/ Application for Employment

Complete all relevant sections of this application form and attach your current CV and covering letter.

1 / Position Details
Position applied for
2 / Personal Details
Family Name / Email
First Name(s) / Telephone
Preferred Name / Cell phone
Address / Work phone
3 / General Information
Are you currently physically located in New Zealand?
If No, please indicate your arrival date: / /
Do you have a current drivers licence?
Full / Restricted / Learners
/ /
Do you have any endorsements or restrictions on your licence? If Yes, please specify below: / /
Do you have any injury or psychological or medical condition, including those caused by gradual process, disease or infection (e.g. hearing loss or occupational overuse syndrome), which may affect your ability to perform the duties of the position satisfactorily OR that may pose a risk of harming yourself or another person, including the risk of infecting another person with an illness?
If yes, please provide details: / /
4 / Criminal Check
Because of the nature of our work and the high standards of integrity and conduct we expect from employees, New Zealand Red Cross carries out a number of pre-employment checks on applicants, including criminal checks.
All job offers by New Zealand Red Cross are subject to a satisfactory Ministry of Justice and/or Police check. If you are shortlisted, as part of the recruitment process you will be required to consent to the release of this information from the Ministry of Justice and/or NZ Police.
The Criminal Records (Clean Slate) Act gives applicants in some circumstance, the right to withhold information about convictions. Applicants who want to know more about the Clean Slate Act should seek independent legal advice or get information from the Ministry of Business, Innovation and Employment helpline on 0800 20 90 20. Information may also be obtained here: http://www.justice.govt.nz/services/criminal-records/criminal-records-clean-slate-act-2004
We expect all applicants to answer the following questions openly and honestly, unless the Clean Slate legislation applies.
Have you been convicted of any offence against the law in New Zealand or any other country? / /
Do you have any criminal charges pending? / /
If you answer yes to any of the above two questions, please provide further information below
5 / Right to Work in New Zealand
To work for New Zealand Red Cross you must be legally entitled to work in NZ. Please attached to this application form verification that you can work in NZ. Acceptable forms of verification include a copy of your NZ/Australian Passport or Birth Certificate, a copy of your NZ Citizen Certificate or a copy of your work visa or resident visa.
Are you a current New Zealand Citizen? / /
Are you a Permanent Resident? / /
Do you hold a current work visa?
Expiry date: / /
Are there any restrictions on the type of work you can do?
If Yes, please specify: / /
6 / Conflict of Interest
To ensure that New Zealand Red Cross can operate in an impartial manner, it is necessary for individuals to declare whether they have any potential conflicts of interest.
Do you have a spouse, partner, relative or household member already working for New Zealand Red Cross? / /
Do you have a spouse, partner, relative or household member currently elected or appointed as an Area Council Member, National Youth Panel or National Board Member of New Zealand Red Cross? / /
Are you now or have you ever in the past been a staff member, volunteer or member for New Zealand Red Cross? / /
If you answered ‘yes’ to any of the above questions, please provide further details below
7 / Privacy Statement
The information which you supply on this application form is solely to assess your suitability for the vacancy you have applied for with New Zealand Red Cross. The information will not be used for any other purpose or supplied to any other party. Staff having direct access to this information include the staff of Human Resources and staff responsible for the recruitment of this position. Under the Privacy Act 1993, you have a right of access to personal information about you held by New Zealand Red Cross and you are also entitled to request information about you to be corrected. This information will be securely held until an appointment is made, after which time it will be destroyed, unless you are the appointee in which case the information will be placed on your Personal file.
8 / Declaration
In assessing my suitability for employment, I hereby authorise:
-  my referees to disclose personal information about me to New Zealand Red Cross.
-  the organisation to collect this information and to disclose it as necessary.
I understand that the information provided to New Zealand Red Cross by my referees is supplied in confidence and that it is evaluative material that will not be disclosed to me.
I declare that I have read the above Privacy Act statement and I am aware of my rights under the Privacy Act 1993
I declare that the information given in this application and the associated material is true and correct to the best of my knowledge and that any incorrect or misleading information or suppression of material facts in this form or any other document may lead to disqualification, or if appointed, to termination of Employment.
By typing your name here you are ‘electronically signing’ this form. A copy of your email and form will be kept for our records.
Signature (type/sign) / Date:

Form – Application for Employment June 2016