APPLICATION FOR EMPLOYMENT
Please note you cannot attach a CV or Cover letter to this application so please utilise this form to give as much information as you can to express you interest and what would be contained in your CV and cover letter. If we require further information we will request this via email
Application date *
Application date
(If no job code listed please type NC)
APPLICANT DETAILS: Name *
APPLICANT DETAILS: Name
Address *
Address
LEGAL ENTITLEMENT TO WORK IN NEW ZEALAND *
If you have a work visa, what is the expiry date?
If you have a work visa, what is the expiry date?
PREVIOUS EMPLOYMENT: Has Pact previously employed you? *
Please note that Pact reserves the right to use any relevant employment related information that it might hold about you as an employee when assessing your suitability for the position you are applying for
Company Address *
Company Address
Start Date *
Start Date
Finish Date *
Finish Date
Contracted Hours *
Company Address *
Company Address
Start Date *
Start Date
Finish Date *
Finish Date
Contracted Hours *
Company Address
Company Address
Start Date
Start Date
Finish Date
Finish Date
Contracted Hours
From
From
To
To
From
From
To
To
From
From
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From
From
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Do you have a current full driver licence? *
Can you drive a manual car? *
Have you ever been convicted of any offences against the law in New Zealand or in any other country (other than minor traffic or parking offences)? *
Do you have any cases pending? *
Are you suffering from, or have you ever suffered from, injuries or medical conditions caused by gradual process, disease or infection (e.g. hearing loss, repetitive strain injuries, back injury), which the tasks of this job may aggravate or contribute to? *
Do you have any other physical or mental conditions not stated above that may affect your ability to perform the duties required for this job? *
Are you on any medications that may affect your ability to perform the duties required for this job? *
Date Available to Start
Date Available to Start
Please tick ALL boxes that you are available for *
Please provide the names of at least two referees (whose consent has been obtained and who may be contacted for a confidential reference.). At least one should be a Supervisor, or Manager whom you have worked for.
Person's Name *
Person's Name
Person's Name *
Person's Name
If you have not been employed before or are returning to work after several years please provide contact details of people from whom confidential (personal) references can be obtained (this person is to be a non family members whom you have known for a minimum of two years).
Please paste your cover letter below
Collection/Storage/Purpose of personal information
The information you provide on this Employment Application Form is being collected and will be held by Pact for the purpose of assessing your suitability for employment and/or re-employment with Pact, which may include subsequent changes in employment within the organisation. This information is also being collected for the purpose of complying with all employment related legislation such as the Accident Compensation Corporation (ACC), and Health & Safety. Failure to complete all sections truthfully will render this application invalid and, should you have been successful in your application, can be grounds for dismissal. Failure to provide accurate information in the medical section may also result in your loss of entitlement to ACC. This information shall be held securely in the organisation's personnel file and only appropriate personnel shall have access to it. No information will be disclosed to third parties without your authorisation except as required by law. you have the right to view your personal information and may request correction if necessary. If your application is unsuccessful it will be held for a period of three months after which it shall be destroyed.
Declaration
Date *
Date
Thank you for your application