/ JOB APPLICATION FORM

Vacancy 035/2018, Business Services Training Facilities Coordinator,

Mt Wellington, Auckland Permanent, Full Time(40 hours per week)

Information for applicants

Thank you for your interest in applying for a position with Fire and Emergency New Zealand.

Please send your completed application to:

Jasmin Deane, Senior HR Advisor, Region 2

Email:

Applications close on Wednesday 21 February 2018 by 5pm

Your application must include:

1.  Application form:

Complete all parts fully on this form and sign and date your application.

2.  A covering letter detailing why you think your skills and experience are a good fit with this role.

3.  A copy of your Curriculum Vitae (CV)

Note:

·  All information that you provide in support of your application will be treated as confidential.

·  You will be advised in writing of the outcome of your application.

·  Written requests for access to, or correction of personal information, in terms of the Privacy Act 1993, should be addressed to the office at which applications close as specified in the vacancy advertisement.

OUR VISION

Leading integrated fire and emergency services for a safer New Zealand
Te Manatū o ngā ratonga ohotata kia haumaru ake ai a Aotearoa

1) VACANCY DETAILS
Vacancy Number
Position
2) NAME
Title / First Names / Surname
3) EMAIL & PHONE
Email Address
Phone Numbers / Home: / Daytime:
Mobile:
4) ADDRESS
5) CURRENT POSITION DETAILS (INTERNAL ONLY)
Position Name / Location
Internal applicants, go directly section 12
External applicants, please complete the following sections.
6) ARE YOU LEGALLY ENTITLED TO PERMANENTLY WORK IN NEW ZEALAND?
o Yes / o No
7) HAVE YOU APPLIED TO WORK FOR FIRE AND EMERGENCY NEW ZEALAND IN THE PAST?
o Yes
o No / If yes, please provide full details.
8) HOW DID YOU HEAR ABOUT THIS ROLE?
9) MEDICAL HISTORY
In line with Fire and Emergency New Zealand obligations under the Health and Safety at Work Act 2015, and the Applicant’s obligations under the Contractual Remedies Act 1979, it is permissible for us to ask questions regarding an applicant’s health status relevant to the position applied for.
Do you currently have or have you previously had any injury or medical condition which would impact on your ability to work in the position you are applying for, or which the tasks of this job may aggravate or contribute to, or for which you are receiving compensation?
o Yes
o No / If yes, please provide full details
10) SECURITY CLEARANCE / CRIMINAL CONVICTIONS
If you are successful in securing this position, you will be required to complete a security vetting consent form.
The declaration of an offence may not preclude your application from being considered. However,
non-disclosure of relevant matters will be seen as misrepresentation and dealt with accordingly.
Note:
·  If you are in doubt as whether or not to declare something, please declare it.
·  It is not necessary to declare parking fines or speeding tickets unless they resulted in a sentence of disqualification or otherwise.
Have you ever been convicted of any criminal offences that are not concealed by the Criminal Records (Clean Slate) Act 2004?
o Yes
o No / If yes, please outline the offence, date, and the sentence issued.
Have you ever been charged with a crime, or are you currently being investigated?
o Yes
o No / If yes, please provide brief details.
11 ) REFEREES

Please provide the details of three people you would like to nominate as referees in support of your application. These people would need to be able to talk to us about your suitability for this position. Please ensure your referees are current, work-related and at least one of your referees is your current/recent manager. We will advise you before we make contact with your referees.

Name:
Position/Organisation:
Telephone: / Work: / Mobile:
Email:
Relationship:
Name:
Position/Organisation:
Telephone: / Work: / Mobile:
Email:
Relationship:
Name:
Position/Organisation:
Telephone: / Work: / Mobile:
Email:
Relationship:
12) PRIVACY OF INFORMATION STATEMENT (PRIVACY ACT 1993) AND DECLARATION
The information you supply in this form (or in other documents supplied with this application form) is collected for the sole purpose of determining your suitability for employment to the position you have applied for above. The information will not be used for any other purpose.
In line with Fire and Emergency New Zealand policy, if you are appointed to this position, selection information about yourself may be supplied to unsuccessful internal candidates who request a review of appointment.
Please consider the declarations below and sign accordingly.
I agree to provide the above information for use by the Fire and Emergency New Zealand in making an employment decision and for personnel use in accordance with the Privacy Act, should I be appointed to the position.
I DECLARE THAT:
·  The contents of my application (including supporting documents) are true and accurate to the best of my knowledge;
·  I have not withheld any information likely to affect the decision to employ me;
·  If I have been unclear about whether or not to provide information, I have provided that information;
·  To the best of my knowledge, the answers to the questions on this form are correct;
·  I understand that if any false information is given, or any material fact is not provided in this form, I may not be employed, or may result in disciplinary action up to and including dismissal from my position in Fire and Emergency New Zealand; and
·  I understand that any false information given on this form may result in my loss of entitlement for any compensation from Accident Insurance.
I hereby authorise the Fire and Emergency New Zealand to obtain such information as they may require from any former employers, existing Fire Service or Fire Brigade files. My signature on this application hereby authorises such former employers to provide to Fire and Emergency New Zealand such information as they may request.
NOTE: For external applicants – you’ll be contacted before Fire and Emergency contacts your referees.
13) I AGREE WITH THE PRIVACY STATEMENT AND THE DECLARATION AS DETAILED ABOVE

SIGNED:

NAME:

DATE:

Fire and Emergency New Zealand Job Application Form, July 2017