Close
Home
About
Our Story
Our People
Our Partners
Services
Social Work
Family Harm Prevention Programmes
Programmes for Parents
Request for Service
Client Stories
News & Resources
Donate
Vacancies
Contact
We’re here to talk06-345 1636
Home
About
Our Story
Our People
Our Partners
Services
Social Work
Family Harm Prevention Programmes
Programmes for Parents
Request for Service
Client Stories
News & Resources
Donate
Vacancies
Contact
We’re here to talk06-345 1636
Employment Application Form
Step
1
of
7
14%
CONFIDENTIAL
To be completed personally by Applicant
Please Note:
The completion of this form does not indicate that there is any obligation on jigsaw whanganui to engage the applicant. The application form is a source of information, which will be used by jigsaw whanganui to assess your suitability for the position for which you are applying. If successful, this information will form part of our personnel records. Failure to supply the information requested would prejudice our ability to assess your suitability for the position
Date of Application
*
DD dash MM dash YYYY
Position applied for
*
PERSONAL DETAILS
Family name:
*
First/Middle names:
*
Residential Address:
*
Street Address
Address Line 2
City
ZIP / Postal Code
Is your postal address different from your residential address?
*
Yes
No
Postal Address:
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone Numbers
*
Email
*
Are you a New Zealand citizen?
*
Yes
No
Do you have the right to work in New Zealand?
*
Yes
No
NZ POLICE VETTING TO MEET REQUIREMENTS OF VULNERABLE CHILDREN’S ACT
Date of birth
*
DD slash MM slash YYYY
Maiden or any other names used
Gender
*
Female
Male
Other
Country of Birth
*
Place of Birth (town/city):
*
NZ Driver Licence No:
*
TERTIARY QUALIFICATIONS:
TERTIARY QUALIFICATIONS
Qualification
Year Gained
Institution
Please fill in the below - click the "+" button to add more qualifications
Are you registered with a professional body?
*
Yes
No
If yes, please specify:
*
Have you ever been subject to a formal complaint regarding your professional practice?
*
Yes
No
If yes, please detail:
*
What languages do you speak?
Please describe the skills you have which are relevant to the position applied for:
*
If your application is successful when could you commence employment?
*
REFEREES
REFEREES
*
NAME
POSITION
PHONE NO
E-MAIL
Please provide name and contact details of at least three referees who have known you for more than two years.
(Two need to be employment related)
LEGAL
Have you been convicted of a criminal offence?
*
Yes
No
Have you ever been the applicant or respondent to a Protection Order?
*
Yes
No
Are you awaiting the hearing of charges in a civil or criminal court of law?
*
Yes
No
If YES to any of the above, please give details:
*
TRANSPORT:
Do you have a current driver’s licence?
*
Yes
No
Do you have any demerit points or endorsements?
*
Yes
No
If yes, please detail:
*
Do you have the daily use of a reliable, registered, warranted and insured vehicle
*
Yes
No
Health
Have you ever suffered from any illness or injury requiring extended time off work?
*
Yes
No
If yes, please detail:
*
Have you had any serious injury, physical or mental illness or other condition now or in the past that may affect your ability to effectively carry out the functions and responsibilities of this position
*
Yes
No
If yes, please explain:
*
Have you ever had problems at work arising from personality clashes, or conflicts with management and/or other staff?
yes
No
If yes, please explain:
*
DECLARATION
I agree with Jigsaw Whanganui discussing this application in confidence with my referees
I consent to the safety checking requirements of the Vulnerable Children’s Act 2014 including NZ Police vetting
My answers in this application are true and not misleading, and there is no further relevant information I have not included
I understand that if Jigsaw Whanganui employs me they are relying on the truth and completeness of my answers, and therefore may terminate my employment immediately and without notice if I have not answered truthfully and completely
I agree with all of the above and that i have answered all questions correctly and honestly to the best of my knowledge
*
Yes
No
Upload your CV
Accepted file types: pdf, docx, Max. file size: 20 MB.
Please upload either a PDF or Word Document - files size can be no larger then 20MB
Upload a cover letter
Accepted file types: pdf, docx, Max. file size: 20 MB.
Please upload either a PDF or Word Document - files size can be no larger then 20MB
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.