Queenstown Lakes District Council

What is the position you are applying for? *

What is your expected salary or wage? (NZD) *

When would you be available to start? *

Title *

Surname *

Postal address *

Contact phone number (after hours) *

Please list any demerit points or endorsements if applicable:

Have you had any criminal convictions or any current actions pending? This excludes any convictions which may be concealed under The Criminal Records (Clean Slate) Act 2004?

If yes please provide details. Minor traffic offences do not need to be disclosed. The Criminal Records (Clean Slate) Act 2004 means you do not have to advise the Council of convictions that happened over seven years ago, if you have had no new conviction since and never been sentenced to a custodial sentence. However, if you have ever had a conviction for a ‘specified offence’ (for example sexual offending against children, young people or the mentally impaired) you are required to tell us. To see the list of offences you would need to tell us about, look at http://www.justice.govt.nz/privacy/clean-slate.html or request a list from the Council

Do you have any commitments which mean you may be unavailable or unable to perform the required work, for example sporting, leisure, community service or Territorial Army commitments?

If yes, please describe:

Health and Safety

Do you have any physical disabilities or medical conditions that might affect your ability to perform the duties required of this position?

If yes, please provide details:

Health Check? *

Yes

No

Please upload your CV. Please include details about your suitability for the position. In particular: work history, education, qualifications, membership on professional bodies, details of professional development, details of references.(br/>

NOTE:

The filename of your CV cannot contain anything other than letters and numbers. The inclusion of other characters ( e.g - / @ etc) will cause your file upload to fail.

You may also upload a cover letter if you wish.

May we contact your referees? *

Yes

No

To prevent spam, please type in the answer to the following simple maths equation.

Submit your application

Declaration: *

Yes

No

A message will be sent to your e-mail address confirming receipt of your application and uploaded documents. PLEASE NOTE: this application form has been tested with Internet Explorer 7 and later versions. If you do not receive an automated email message after submitting your application please contact hr@qldc.govt.nz

Position information

Personal details

Health and Safety

Upload your CV

Submit your application

Position information
What is the position you are applying for? *
How did you find out about this position? *
What is your expected salary or wage? (NZD) *
If Other, please specify
When would you be available to start? *
Personal details
Title *
First name *
Surname *
Email address *
Postal address *
Contact phone number (during work hours) *
Contact phone number (after hours) *
Do you hold a current NZ drivers license? *	Yes No
Please list any demerit points or endorsements if applicable:
Demerits or endorsements
Have you had any criminal convictions or any current actions pending? This excludes any convictions which may be concealed under The Criminal Records (Clean Slate) Act 2004?
Criminal convictions? *	Yes No
If yes please provide details. Minor traffic offences do not need to be disclosed. The Criminal Records (Clean Slate) Act 2004 means you do not have to advise the Council of convictions that happened over seven years ago, if you have had no new conviction since and never been sentenced to a custodial sentence. However, if you have ever had a conviction for a ‘specified offence’ (for example sexual offending against children, young people or the mentally impaired) you are required to tell us. To see the list of offences you would need to tell us about, look at http://www.justice.govt.nz/privacy/clean-slate.html or request a list from the Council
Details of convictions:
Do you have any commitments which mean you may be unavailable or unable to perform the required work, for example sporting, leisure, community service or Territorial Army commitments?
Commitments?	Yes No
If yes, please describe:
If you chose other, please specify:
Health and Safety
Are you legally entitled to work in New Zealand? *
Do you have any physical disabilities or medical conditions that might affect your ability to perform the duties required of this position?
Physical Disabilities? *	Yes No
If yes, please provide details:
If you are shortlisted for this position, are you prepared to undergo a medical examination by a doctor nominated by the Council (at its expense) to determine your ability to perform your job, prior to us making a decision about your application?
Health Check? *	Yes No
Upload your CV
Please upload your CV. Please include details about your suitability for the position. In particular: work history, education, qualifications, membership on professional bodies, details of professional development, details of references.(br/> NOTE: The filename of your CV cannot contain anything other than letters and numbers. The inclusion of other characters ( e.g - / @ etc) will cause your file upload to fail.
Browse for your CV: *	Max Filesize: 2000kb. \| Allowed File Types: pdf, doc, docx, ppt, wps
You may also upload a cover letter if you wish.
Browse for your cover letter:	Max Filesize: 1000kb. \| Allowed File Types: pdf, doc, docx, wps
May we contact your referees? *	Yes No
If no, please tell us why:
To prevent spam, please type in the answer to the following simple maths equation.

Submit your application
By submitting this form I declare that to the best of my knowledge the answers I have given are true, correct and complete and I understand that if any false information is given, or any material fact supressed, any employment offer may be withdrawn, or if I am employed, I may be dismissed.
Declaration: *	Yes No

A message will be sent to your e-mail address confirming receipt of your application and uploaded documents. PLEASE NOTE: this application form has been tested with Internet Explorer 7 and later versions. If you do not receive an automated email message after submitting your application please contact hr@qldc.govt.nz