Please fill in all fields.
Date of Birth
POSITION APPLIED FOR
Have you worked in a kiwifruit orchard before?*
If Yes, where
If yes, what job?
Are there any days you are not available to work?* If Yes please give details.
Do you have another job or personal circumstances that may interfere with your work here?* If Yes please give details.
If you get the job how long are you intending to work?
Do you need accomodation? ( accomodation can be provided)
SKILLS AND LICENSES
List relevant qualifications/ certificates/ licences - e.g. first fid, forklift
Do you have a car?
Name of last employer
Employers Phone number
Are you legally entitled to work in New Zealand?*
Cover Letter if any
HEALTH AND SAFETY
Do you have a medical, allergic or physical condition or injuries that may affect your ability to effectively carry out your duties?*
Are you currently receiving medical treatment or are you taking prescription medicine?*
Do you need to bring prescription medicine to work?*
Do you have a hearing disability?*
Have you ever suffered a back injury?*
DECLARATION AND CONSENT
A: I consent to DNA CORPORATE COMMERCIAL seeking information, on a confidential basis, about me from any previous employers or referees and authorize the information sought to be released for the purposes of ascertaining my suitability for the position for which I am applying. The information received by DNA CORPORATE COMMERCIAL is supplied in confidence, and evaluative material will not be disclosed. I also consent to DNA CORPORATE COMMERCIAL seeking information from Government Agencies or providing information to Government Agencies for employment related purposes.
I agree to the terms above*
Tairua, New Zealandinfo@dnacorporate.co.nz