Application Form (All fields are required)
1. Advertising Avenue:
Where did you see this position advertised?
2. Drivers Licence:
Do you hold a current, clean NZ drivers licence?
3. Other names :
Are you known by any other names?
4. Declaration :
I confirm that the information I’ve provided in this application is accurate to the best of my knowledge. I understand that providing false or misleading information could affect my suitability for employment and may lead to my application being rejected. Additionally, any inaccuracies in my medical history could impact my eligibility for ACC benefits.
5. Health:
If you are offered employment, the offer is made subject to your obtaining a full medical clearance for the position following the completion of our pre-employment medical. Do you agree to undergo a medical examination if required?
6. Health:
Do you have any health related issues (including stress) that may impact on your ability to perform the tasks listed in the position description for the job that you are applying for?
7. Health:
Have you had any injury or medical condition caused by gradual process, disease or infection that may be aggravated or further contributed to by the task of the role?
8. Referees:
For the purpose of compliance with the Privacy Act 1993, do you consent to the Council contacting your current employer for the purpose of reference checking?
9. Due Diligence Checks:
Hauraki District Council may undertake a range of due diligence checks as part of the selection process. This might include checks including but not limited to qualification verification, credit check, criminal record check. Do you agree to due diligence checks at the discretion of HDC?
10. Civil or Criminal Offence :
Have you ever been convicted of a civil or criminal offence in New Zealand or in any other country (not including any concealed under the Criminal Records (Clean Slate) Act?
11. Criminal Convictions :
Are you awaiting the hearing of charges in a civil or criminal court of law?
12. Legal right to work in NZ:
Do you currently have the legal right to work in NZ
13. Salary Expectations :
Please indicate your expected salary range?
14. Appeal:
Why does this position appeal to you?
15. Qualifications:
Which of the below qualifications do you hold?
16. Experience:
How many years experience do you have in a similar role?
17. Experience:
Have you previously worked in the local government sector?
18. Experience:
Which of the below areas do you have experience in?
19. Knowledge:
Which of the areas below do you have working knowledge in?
20. Values:
What do you consider to be the 4 most important values in a workplace?
21. Interests or Community activities:
What are your main out of work interests?
22. Weekends On Call Roster :
Are you prepared to weekends/overtime on a on call roster
23. Employment History:
Please provide details of where you currently work, what the role is and why you are considering leaving.
24. Employment History:
Please provide details of any other employment (prior to your current employer) in the past 10 years and give reasons for leaving.
25. Employment History:
Have you ever brought a personal grievance against a previous employer?
26. Employment History:
Have you ever been through disciplinary action that resulted in a termination?
27. Health:
Have you received ACC assistance in the last 5 years as a result of work-related injury or illness?
28. Referees:
Give the name, address, email contact details and telephone numbers of at least two referees, preferably from where you have worked within the last five years.
These referees may be contacted by Council for valuative purposes.
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