Avsec form 4.16

Application Form

Section 1: Personal Details

First Name
Surname
Preferred Name
Title (ie. Mr, Mrs, Miss)
Email Address
Home Address
Contact Phone Number
Title of position you are applying for:
Location of position you are applying for:
Are you a New Zealand or Australian Citizen or NZ Permanent Resident? (if no, please outline your current visa status below) / Yes No
Current Visa status:
Have you previously been employed by the Aviation Security Service in any role? / Yes No
If yes, please give details:
Have you previously applied for a position with the Aviation Security Service? / Yes No
If yes, in what year did you apply?
Where did you first see this vacancy advertised? / (select one)
Seek
Trademe
Government Jobs
Aviation Security Service website
Referral (please name the Avsec employee who referred you below)
Other (please provide details below)


Section 2: Criminal History

Have you ever been:
a) Convicted of an offence for which you received a custodial sentence? / Yes No
If yes, please provide details:
b) Convicted of any other offence/s?
(including traffic offences) / Yes No
If yes, please provide details:
c) Are you currently facing any criminal charges? / Yes No
If yes, please provide details:
Avsec is a high-security organisation which requires additional security vetting.
Please note that the Clean Slate Act 2004 does not apply to applicants seeking employment with the Aviation Security Service, i.e. a full disclosure of criminal convictions is required, whether or not they are older than 7 years.

Section 3: Medical History

a) Have you had an injury caused by gradual process, disease or infection that may be aggravated or contributed to by the tasks of this job? (eg. hearing loss, repetitive strain injuries) / Yes No
If yes, please provide details and please advise what accommodation or arrangement you would require to be able to carry out the job to the required standard:
b) Do you have any disabilities or medical conditions that may prevent you from performing the duties of the position to the required standards? / Yes No
If yes, please provide details and please advise what accommodation or arrangement you would require to be able to carry out the job to the required standard:

Section 4: Referees

Please provide details of at least two work-related referees we can contact:

Referee Name / Position/Company / Phone Number
1.
2.
3.
The Privacy Act 1993 requires the Aviation Security Service to obtain your approval to contact a referee for information, generally about character and previous work performance. Your approval to contact these referees, if applicable, will be sought at the interview stage. No one will be contacted without your consent.

Section 6: Declaration

I acknowledge that:

a) I have disclosed any illness or injury that might affect my capacity to undertake the duties involved in this position;

b) All representations that I have made in applying for this position (including those about my qualifications and experience) are true and correct; and

c) I have not deliberately failed to disclose any matter that may materially influence the Aviation Security Service’s decision to employ me

d) I understand that providing false, incomplete or misleading information will be grounds for summary dismissal

Signature:
Date:

Please print your name in the signature section above if you are electronically completing this form. By doing so, you are accepting the above declaration. Please note, you will be asked to sign a physical copy of this form at a later stage in the application process.

Please advise that you have attached the following documents:

Covering Letter (supporting your application)

Curriculum Vitae

Please send your completed application form, CV and covering letter to: