Application Form
(All fields are required)
1. Advertising Avenue:
Where did you see this role advertised?
2. Supplementary Information:
Have you been employed by STDC before?
3. Interest in Role:
Why does this role appeal to you?
4. Qualifications:
What qualifications do you currently hold?
5. Experience:
How many years of experience have you previously had as a lifeguard?
6. Legal Work Status:
Do you have unrestricted working rights in New Zealand (ie are you a NZ or Australian Citizen or a Permanent Resident of New Zealand?
7. Legal Work Status:
If you answered 'Other' to question 5, please explain below what type of visa you hold and the conditions of it.
8. Physical and Mental Health:
Do you have any conditions that would require special modifications or equipment in the workplace (ie blindness, severe arthritis, low mobility, hearing loss etc)
9. Physical and Mental Health:
This position requires you to do physical activity on a daily basis. Are you physically capable of ding these tasks? (Moving swim and lane equipment, potential life saving activity, standing long periods, walking frequently over shift, hosing down and cleaning duties)
10. Physical and Mental Health:
Do you have any allergies? If so, please list below:
11. Physical and Mental Health:
Do you suffer from any physical or mental conditions, injury or other disability which may adversely affect your work performance, regular attendance at work or the personal safety of yourself or others? Please provide details below.
12. Physical and Mental Health:
Are you a member of any volunteer agency that may require you to attend callouts ie FENZ, St John etc. Please provide detail below.
13. Hearing Health:
Have you previously worked in a noisy environment? Please provide details below.
14. Hearing Health:
Do you routinely wear hearing protection?
15. Hearing Health:
Have you ever had a hearing test? (Audiogram)
16. Hearing Health:
Date of your most recent hearing test?
17. Hearing Health:
Have you ever been referred to an audiologist or ear specialist?
18. Visual Health:
Do you need to wear glasses or lenses of any sort to help you see clearly or perform your work? Please provide details below. Can you wear sunglasses?
19. Hazardous Substance Exposure:
Have you ever had any health problems related to contact with exposure to chemicals, fumes, solvents, skin irritants, asbestos or dust? Please provide details below.
20. Pre-Employment Screenings:
STDC requires all new employees to undergo a pre-employment drug screening test and police criminal history check. Do you consent to undertaking a pre-employment screening?
21. Pre-Employment Screenings:
Have you ever been convicted in a court in New Zealand or any other country? Please provide details of the conviction/s below.
22. Pre-Employment Screenings:
Are there any charges against you yet to be heard in a NZ court? Please provide details of the charge/s below.
23. Other:
Do you have a clean NZ drivers licence? If yes, what class?
24. Other:
Do you have any ongoing ACC claims? Please provide details below.
25. Start:
If you were successful in this role, when could you start?
26. Declaration and Consents:
I consent to this information being used by STDC to make decisions regarding my employment and for ongoing monitoring of the hazards and risks that I will be exposed to while employed by STDC.
27. Declaration and Consents:
I declare to the best of my knowledge that the information I have given in this questionnaire is correct, true, complete and accurate and I have not omitted any information or provided any misleading information.
I understand that giving false or misleading information or suppressing information will be construed as misconduct or serious misconduct and disciplinary action may be taken against me if I am employed by STDC.
File size limit: 2MB each file. We accept .pdf, .doc and .docx.
Your upload file is over the size limit. Please try again.
Save For Later
Submit
