Application Form
(All fields are required)
1. Advertising Avenue:
Where did you see this position advertised?
2. Residency:
Which best describes your residency status?
(Evidence will be required if you are interviewed).
3. Employee:
Are you currently or have you previously been employed by Eastland Group?
4. Experience:
How many years of relevant experience do you hold for this position?
5. Overview :
Please explain in a short paragraph, your understanding of New Zealand Health and Safety legislation.
6. Software :
Which computer programs are you proficient on?
7. Efficiency:
How would you rate your keyboard skills?
8. Remuneration Expectations:
Please indicate your annual salary expectations for this role
9. Availability :
Please indicate when you are available to start if you were successful?
10. Appeal:
Please outline why this position appeals to you
11. Best Fit:
Why do you feel you are the best person for this job?
12. Criminal History:
Do you have any criminal convictions, not including any concealed under the Clean Slate Act?
13. Criminal History:
Are you awaiting the hearing of charges in a civil or criminal court?
14. Medical:
Have you had any injury or medical condition caused by gradual process, disease or infection e.g. hearing loss, sensitivity to chemicals, Occupational Overuse Syndrome (e.g. tendonitis, occupational Asthma, RSI, Carpal Tunnel, Tennis Elbow) disease, allergy or infection that may be aggravated or further contributed to by the tasks associated with this position?
15. Medical:
If shortlisted, do you consent to Eastland Group obtaining your ACC claims history records by you completing the Pre-Employment Check - Request for ACC Claims History form (ACC6213)?
16. Medical:
Do you have any known health condition of any kind, which may affect your ability to effectively carry out the functions and responsibilities of the position applied for?
17. Medical:
Are you on any medication, which may affect your performance in the position you have applied for?
18. Medical:
Do you agree to undergo a pre-employment medical examination and drug test?
19. Privacy Act Consent :
Do you consent to Eastland Group retaining the information contained in this application form for the purposes of considering your suitability for any other position which may arise with the business in the future?
20. Declaration:
I declare that to the best of my knowledge the information I have supplied in this application form and/or in my Curriculum Vitae is true and correct. I understand that if any false or deliberately misleading information is given, or any material fact suppressed, I will not be accepted, or if I am employed, my employment may be terminated.
I further understand that any offer of employment if made is conditional on obtaining a full medical and drug clearance through the companys pre-employment medical examination and drug test. I also understand that the information requested within this application form is sought to establish my suitability for the position that I am applying and that if I do not provide such information then this application for employment may be rejected.
21. Success:
What would make a person successful in this role?
