CONFIDENTIAL

APPLICATION FOR EMPLOYMENT

SUPPORT STAFF

  • This information is being collected to enable St Cuthbert's College to recruit the most suitable person for the position below. It is therefore to be personally completed and signed by the applicant. All information provided will be treated in accordance with the Privacy Act 1993.
  • A current curriculum vitae may accompany this form outlining professional experience, personal strengths, interests, etc and elaborating on information given on this form.
  • You should also include a letter outlining your reasons for applying for the position and what you think you can add to St Cuthbert's College.
  • We thank you for taking the time to complete our application form and appreciate your interest in St Cuthbert’s College.

Position:Boarding Administrator (part time permanent)

Surname:First Names:

Address:

TelephoneNumber(s): Work:Home:

Mobile Phone:

E-mail Address:

What notice are you required to provide in your current employment?

[eg two weeks, one month]

Eligibility

I am legally eligible to work in New Zealand by virtue of being:

A citizen of New Zealand

A permanent resident of New Zealand

A holder of a current Work PermitExpiry Date:

[Evidence of your right to work will need to be sighted if short-listed for interview].

Health

Have you any injuries, disabilities or medical conditions which would prevent or restrict you from performing any aspects of the job for which you are applying, or that the job is likely to exacerbate? / Yes No
Have you ever suffered from any overuse injuries, eg RSI OOS? / Yes No
Are you taking any drugs or medicine which would prevent or restrict you from performing any aspects of the job for which you are applying? / Yes No

If you have answered yes to any of the questions above, please give details:

Education and Training

Education:

Please list your qualifications:

Outdoor experience and instructing

Details:

What training courses, seminars, workshops, etc. relevant to your work have you attended: eg. Outdoor, mentoring, academic. (Please state dates and institutions.)

Details:

What hobbies, musical abilities, interests, sports, clubs or community activities are you involved in that are relevant to the role?

Details:

Previous Employment: (Show most recent employer first)

  1. Name and address of employer:

From:To:

Position Title:

Duties:

May we contact this employerYes No

  1. Name and address of employer:

From:To:

Position Title:

Duties:

May we contact this employerYes No

  1. Name and address of employer:

From:To:

Position Title:

Duties:

May we contact this employerYes No

What was your salary range at your last/current position?$

What other benefits (if any) did you receive?

What is your salary expectation for this position?$

Have you ever worked for St Cuthbert’s College before? Yes No

If ‘yes’, please provide details:

Position heldDates of Employment[From when to when]

Secondary Jobs

If offered the job you are applying for, will you concurrently hold any secondary jobs?

Yes No

If ‘yes’ please provide details:

Professional Bodies

The Ministry requires you to disclose all previous findings made against you by any professional body in relation to your work (eg NZ Physiotherapy Board, NZ Institute of Chartered Accountants etc).

Have there been any findings against you?Yes No

If ‘yes’ please provide details:

Are there any matters concerning you currently before any professional body?

Yes No

If ‘yes’ please provide details:

Additional Information

Do you have a spouse, partner, relative, or household member working at St Cuthbert’s College or at another school? Yes No

If ‘yes’ please provide details:

Do you have a child attending St Cuthbert's CollegeYesNo

Is there any commitment paid or unpaid, that you have at this time that may prevent you from fulfilling the requirements of the role?

Yes No

If yes, please provide details:

Referees

Please provide the names and contact details of a least three referees who can speak about your ability to perform the role. This may include your previous employers [as listed above]. By providing the details, you approve of these referees being contacted by St Cuthbert’s College.

  1. Referee’s Name

Position [did you report to this person?]

Company

Company Phone Numberand/or Mobile

  1. Referee’s Name

Position [did you report to this person?]

Company

Company Phone Numberand/or Mobile

  1. Referee’s Name

Position [did you report to this person?]

Company

Company Phone Numberand/or Mobile

The College will contact these people on a confidential basis and you will not be entitled to access this information.

Criminal Matters (Criminal Records (Clean Slate) Act 2004)

Given the special nature of the College as an educational institute for children, we need to know if you have any prior criminal convictions or if any criminal matters are pending within the last seven consecutive years.

Have you ever been charged or judged guilty of any offence against the law?

YesNo

If ‘yes’ please provide details and dates

[Please note, that since April, 2002,it is mandatory to have all new personnel within educational and child care facilities, police vetted (Education Standards Act 2001, Part 1: Section 18 78C, 78CA, 78CB and Part 1: Section 37 139 AZD), therefore if you were selected to be employed with St Cuthbert’s College, Police Vetting is required.]

Declaration and Authorisation

If unsuccessful, I authorise the College to keep this application for 12 months from our last contact for consideration for any future vacancies.

YesNo

Ideclare that the information provided on this form and any supplementary information provided in support of my application is true and accurate and provides a balanced and complete view of the details relevant for considering me for employment.

I understand that any incorrect, misleading or omitted information may disqualify me from appointment, or if appointed, that my employment may be terminated.

Signature of ApplicantDate

1

J:\HR lists and Forms\Application Form 2009 Support Staff.docx