application form non teacher position updated 20141
DESCRIPTION
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CONFIDENTIAL APPLICATION FOR EMPLOYMENT
This information is being collected to enable Rangi Ruru Girls School to recruit the most suitable person for any available positions. It is therefore to be personally completed and signed by the applicant. All information provided will be treated in accordance with the Privacy Act 1993. The completed application will be received and held by the Principal and may be accessed and held by the Payroll Administrator and/or the Business Manager.
A current curriculum vitae may accompany this form outlining professional experience, personal strengths, interests, etc. and elaborating on information given on this form.
You should also include a letter outlining your reasons for applying for the position and what you think you can add to Rangi Ruru Girls School.
Position applied for ______________________________________________ Temporary Period available for temporary work ________________________ Permanent Are there any days you are unable to work? __________________ Please specify _____________________________________________
Personal details
Surname _________________ Preferred form of address Mr/Mrs/Ms/Miss/No title ______
First names _______________________ Email ____________________________
Address __________________________________________________________
Telephone number ____________________ (day) ____________________ (evening)
Emergency contact Name _________________________________ Telephone _________________
Address ________________________________________________________
Relationship to you _________________________________
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Are you a New Zealand citizen? Yes No
If NO, do you have permanent residency? Yes No
If NO, do you have a work permit? Yes No
You may be required to provide your passport as evidence.
Educational details Dates Level achieved/ Secondary school/technical institute/university From To qualification obtained
Employment history
Present or most recent employer
Company name and address
_____________________________________________________________________
____________________________________Position held ________________________
Dates of employment From ___________________________ To ___________________
Describe duties of position ___________________________________________________
_____________________________________________________________________
Name of Supervisor/Manager _________________________________________________
Reason for leaving ________________________________________________________
Do you authorise Rangi Ruru to contact the employer listed above for the purposes of reference checking? Yes No
Previous employer Company name and address _________________________________________________ _____________________________________ Position held ______________________
Dates of employment From __________________________ To _____________________
Describe duties of position __________________________________________________
____________________________________________________________________
Name of Supervisor/Manager ________________________________________________
Reason for leaving _______________________________________________________ Do you authorise Rangi Ruru to contact the employer listed above for the purpose of reference checking? Yes No
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Referees (excluding relatives and personal friends) Name Company Position Telephone
___________________________________________________________________
___________________________________________________________________
I authorise Rangi Ruru to contact the referees and employers listed above to obtain information about my character and previous employment, and authorize such persons to disclose personal information.
Signature __________________________________________ Date _______________ Health and physical record Do you have any medical condition or disability which may limit your ability to perform the job for which you are applying? Yes No If YES, what can be done to accommodate your limitation?
__________________________________________________________________
__________________________________________________________________
Have you ever had an injury or medical condition caused by gradual process, disease, or infection - for example; hearing loss, sensitivity to chemicals, occupational overuse injuries - which the tasks of this job may aggravate or contribute to? Yes No If YES, please detail
__________________________________________________________________
__________________________________________________________________
Extra-curricular experience/interests/community involvement
Criminal convictions Have you been convicted of any offences during the last ten years or are you currently awaiting the hearing of any charges? If YES, give details Yes No
__________________________________________________________________ Any appointment will be dependent on a satisfactory Police vet. Required under the Education Standards Act 2001
Payment of wages If selected, I agree to the payment of my wages by direct credit to a nominated bank account in accordance with my employment contract with Rangi Ruru Girls School.
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Signature ____________________________
Declaration I declare that the information provided in this application and in the enclosed documentation is correct to the best of my knowledge. I understand that, if any false information is given or any material facts are suppressed, I may not be accepted or, if I am employed, I may be dismissed.
Applicants signature __________________________________________ Date ________