Application for Employment

Mon, 12/06/2010 - 23:23 | by admin

Thank you for your interest in employment with Aotea Pathology Ltd. Please complete this application form and submit along with your curriculum vitae and a cover letter. The information you provide in your application will provide us with evidence of your skills, qualifications and experience, and if you do not provide this information we will be unable to fully assess your suitability for employment. Please note that your documentation will not be returned to you and if you are successful it will form part of your employment records with us. Unsuccessful applications will be kept for a period of 12 months, after which time they will be destroyed in accordance with the Privacy Act. If you have any queries about our selection process, please contact the Human Resources team on (+64 4) 381 5900 or email humanresources@apath.co.nz.

Your uploads

Please upload only .doc, .docx, .rtf, .txt, or .pdf files. If you upload any other file type, the system will crash and you will need to re-upload all documents (but only the file types listed above)

Position Applied For: *

Position ID:

Upload your cover letter:

Upload your resume:

Upload any other relevant document:

Personal Details

Title:

Surname:

First Name(s):

Known As:

Address:

Contact Phone Numbers:

Contact Email: *

Your work status

I am a New Zealand Citizen:

yes

no

I am a Permanent Resident of New Zealand:

yes

no

I am a Work Permit holder:

yes

no

Details:

Employment History

Current employer (or most recent employer):

Position Held:

Key Responsibilities:

Dates of employment:

Reason for leaving:

Educational Background

Qualifications:

(i.e. list educational institution, dates and subjects/majors)

Other Courses:

(i.e. list certificates, licences or relevant courses)

Level of computer skill:

(i.e. your typing speed, familiarity with software packages)

Other languages:

(i.e. language in which you could hold a conversation or act as Translator)

Referees

Name:

Relationship:

Contact Details:

(Phone and Email)

Name:

Relationship:

Contact Details:

(Phone and Email)

Drivers Licence

Complete for positions requiring you to drive.

Do you have a current drivers licence?:

yes

no

If yes: Level and classes?:

Have you completed a defensive driving course?:

yes

no

Do you have any demerit points or licence endorsements?:

yes

no

If yes, please provide details:

Professional Registration

Complete for positions requiring Professional Registration.

Do you have a current New Zealand Practising Certificate/Registration?:

yes

no

If yes, provide number, and first year of registration:

Have you ever been denied professional registration or had registration removed?:

yes

no

If yes, please provide details:

Have you ever been subject to a professional disciplinary inquiry?:

yes

no

If yes, please provide details:

Health Status

Do you or have you suffered from any injury or medical condition caused by a gradual process, disease or infection (e.g. occupational overuse syndrome, hearing loss, chemical sensitivity) which this job may aggravate or contribute to?:

yes

no

If yes, please provide details of the injury/medical condition and how this might this affect your work:

Do you have any other health condition or disability which could affect your ability do this job?:

yes

no

If yes, please provide details:

Do you require any special services or facilities to carry out this position’s duties, in addition to what may be listed above?:

yes

no

If yes, please provide details:

Criminal Convictions

Our work involves liaising with members of the public and the health care community, and managing confidential medical information. if you become a preferred applicant you may be required to undergo a police security check prior to any offer of employment being made.

Have you ever been convicted of a criminal offence (other than a minor traffic offence) in New Zealand or any other country?:

yes

no

Do you have any criminal charges pending, in New Zealand or in any other country?:

yes

no

If you answered yes to either of the questions above, please list the criminal convictions or pending charges below, except those covered by the Criminal Records (Clean Slate) Act 2004:

Applicant Declaration

I declare that the information I have provided in this application and accompanying documentation is, to the best of my knowledge, true and correct and no relevant material or information has been omitted.
I understand that any false or misleading information related to a medical condition may result in a work related injury claim not being accepted, and/or affect my eligibility for payment.
I consent to verbal or written information being sought about me on a confidential basis from the referees I have nominated in this application and my curriculum vitae and I authorise the information requested to be released. I understand that the information that is supplied in confidence is evaluative material and will not be disclosed to me as allowed in terms of the Privacy Act 1993. I also understand that my current employer will not be contacted without my consent, unless I am an employee of Aotea Pathology Ltd, in which case my current manager may be contacted.
I understand that the information supplied in my application will be used by Aotea Pathology Ltd in assessing my suitability for employment.
I understand that any incorrect, misleading or omitted information in respect to this application or my curriculum vitae may disqualify me from consideration for this position or, if appointed, could result in termination of my employment.

The information provided in this application will be used to assess your application for employment. If unsuccessful for this position, you may be considered for other positions in Aotea Pathology Ltd within the next 12 months.

Do you consent to your details being given to other departments for this purpose?:

yes

no

Generated CSV:

This will hold the generated CSV sent to admin. It is not shown to the user. Do not delete this field. Anything uploaded here will be deleted.

Website design by Movemedia