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Legal first name
Legal last name
Also known as
Address - where you live
Primary contact number
Email address
Position applied for
Interests/Hobbies
When are you able to commence employment?
Availability
What is your highest level of qualification?
Do you have a New Zealand drivers licence?
No
Learners
Restricted
Full
What drivers licences classes do you hold?
Are you legally entitled to work in New Zealand?
Yes
No
Please describe your latest work position and the following information:
Last/present employer
Position title
Start date
End date
Key responsibilities
Reason for leaving
Reference #1
Name
Company
Position
Phone number
Email
Reference #2
Name
Company
Position
Phone number
Email
Have you or do you suffer from any of the following?
Asthma
Diabetes
High Blood Pressure
Arthritis
Hearing or sight impairment
Dermatitis
Heart conditions
HIV/TB/Hepatitis
Allergies
Blackouts/Fits/Seizures
Epilepsy
Hernia
Do you wear glasses?
Yes
No
Have you suffered any serious injury or illness that may affect your ability to effectively carry out the functions and responsibilities of this position?
Yes
No
What is your current Covid-19 vaccination status?
Vaccinated
Unvaccinated
Would rather not say
Are you taking any medication which may affect your ability to carry out the duties for this required position?
Yes
No
If yes, please provide details:
Do you have any allergies?
Yes
No
If yes, please provide details:
Do you consent to undertake a pre-employment drug and alcohol screen to determine your ability to perform the job you have applied for? (Note: Te Arawa Mahi carries our mandatory pre-employment drug testing. An applicant returning a non-negative result will not be considered for employment)
Yes
No
If requested, do you agree to undergo a medical examination to ascertain your ability to perform the job you have applied for?
Yes
No
Do you have any criminal convictions, not including any concealed under the Criminal Records Clean Slate Act?
Yes
No
If yes, please provide details:
Have you ever been convicted of an offence that carried a penalty of two or more years imprisonment?
Yes
No
If yes, please provide details:
Are there any personal circumstance known to you that would affect your ability to perform your duties on a full-time basis?
Yes
No
If yes, please provide details:
Have you ever been dismissed from employment for any reason?
Yes
No
If yes, please provide details:
Emergency contact name:
Emergency contact phone number:
How did you hear about Te Arawa Mahi?
Friend
Te Arawa Fisheries website
Work to Play website
Billboard
Agency
Kiwifruit Jobs NZ
General Media
Radio
WINZ
Trade Me
Driving past
NZ Kiwifruit Growers Inc
Giggle TV
Backpacker forums
RJS
Returnee
Social Media
Newspaper
Other
By submitting this form you acknowledge that Te Arawa Mahi may see information from or provide information to Government Agencies including WINZ for employment related purposes and where we are legally obligated to do so. In submitting this information to Te Arawa Mahi, you confirm your agreeance with the business retaining this information for recruitment purposes. Te Arawa Mahi confirms that all information will be kept secure and confidential in compliance with the Privacy Act 2020.
Yes
No
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Ehara taku toa i te toa takitahi engari he toa takitini
We come not with our own strengths, but bring with us the strengths of our iwi, hapu and whanau together.
