Application Form
(All fields are required)
1. Advertising Avenue:
Where did you see this role advertised?
2. Residency:
Do you have New Zealand residency?
3. Residency:
If you are not a NZ resident, do you have a NZ work permit?
4. Experience:
Do you have a recognised qualification from within a Building Industry?
5. Experience:
If you answered 'yes' to the above question please outline your qualifications below.
6. Experience:
Do you have experience in the development and auditing of operating systems and procedures?
7. Experience:
If you answered 'yes' to the above question, please provide a description of your experience below.
8. Experience:
Do you have knowledge of the Building Act 2004 and associated regulations?
9. Experience:
If you answered 'yes' to the above question, please describe your knowledge below.
10. Experience:
Do you have experience working with Building Consent Authority Accreditation Regulations?
11. Experience:
If you answered 'yes' to the above question, please provide a description below.
12. Experience:
Do you have previous Local Government experience working in a similar role?
13. Experience:
If you answered 'yes' to the above question, please provide a written description relating to your previous exprience below.
14. Experience:
Please provide a written description of your previous customer service experience
15. Attributes:
This position requires someone with the ability to multitask and prioritise work to meet agreed deadlines. Are you able to demonstrate this ability?
16. Attributes:
If you answered 'Yes' to the above question, please provide a written example of when you have demonstrated this ability.
17. Interview:
If offered an interview, are you able to attend an initial interview at our Hawera offices, or prefer to participate in an interview via Skype due to distance from Hawera.
18. Interview:
If invited to an interview, would you want to bring your support person/group or whanau?
19. Interview:
If you have answered Yes to the above question, how many people?
20. Start Date:
If appointed to the position being applied for, what date would you be available to start work?
21. Driver’s Licence:
Do you have a current driver’s licence?
22. Attendance Record:
Have you been absent from work, other than for annual holidays or sick leave for 5 or more consecutive days the past 5 years?
23. Attendance Record:
If you have answered Yes to the above question, please state reason and duration.
24. Declaration of injury/or pre-existing condition that may affect you in this role.:
Do you suffer from any illness, injury or other disability which may adversely affect your work performance, regular attendance at work, personal safety of yourself or others?
25. Declaration of injury/or pre-existing condition that may affect you in this role.:
If you have answered Yes to the above question, provide details.
26. Declaration of injury/or pre-existing condition that may affect you in this role.:
Describe any disabilities or impairments that you have or have had in the past.
27. Declaration of injury/or pre-existing condition that may affect you in this role.:
With reference to the above question, describe any aids or modifications to the workplace that you may require to work here.
28. Declaration of injury/or pre-existing condition that may affect you in this role.:
Should your application be successful, would you agree to attend a Registered Health Professional nominated by the South Taranaki District Council as and when required and also undergo a drug and alcohol pre-employment test?
29. Court Convictions:
Have you ever been convicted in a court in New Zealand or any other country?
30. Court Convictions:
Are there any charges against you yet to be heard?
31. Court Convictions:
If you have answered Yes to either of the previous two questions, please provide brief details:
32. Work Referees:
Please nominate two people able to comment on your ability to perform the duties of the position applied for. (Please provide: Name, Address, Phone and Relationship to applicant).
33. Work Referees:
Can the above referees be contacted for reference checking purposes and be authorised to disclose such information that may be required.
34. Financial:
Have you entered into bankruptcy or any material accommodation with creditors?
35. Financial:
If you have answered Yes to the above questions, please give details.
36. Other:
Are there any other issues, such as disciplinary or dismissal matters, which would have a bearing on your appointment?
37. Declaration:
I declare that the information provided in this application and CV, is correct. I understand that falsification; deliberately misleading; or, suppression of information, will be grounds for instant dismissal.
