CECL Application Form

Employment Application

Fill the form below accurately indicating your potentials and suitability to job applying for.
Position Applied For
Have you been referred by an existing CECL Employee?
Personal Details
Name:*

First NameLast Name
Birth Date*

MonthDay
Phone Number
Year
E-mail Address:
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ethnicity
IWI
Legal Work Status
Are you legally entitled to work in New Zealand?*
Education
Name of secondary school attended
Trade Qualifications*
Job Skills & Training
Describe your skills:*
Training or Certifications:*
Additional Information
CECL are proactive with training and upskilling staff, please let us know if you require assistance with any of the following:*

WritingReadingNumeracyNone
To help us help you, tell us which way you find easiest to learn a new task by:*

DemonstrationVerbal instructionListening & taking notesBeing actively involved
Employment History
Present or Most Recent Employer
Company*
Address:
Position Held*
Main Duties*
Number of hours worked per week?*
Length of service*
Reason for leaving*
For the purposes of compliance with the Privacy Act 1993 do you consent to the company contacting your present employer?*

YesNo
Next Most Recent Emplolyer
Company*
Address
Position Held*
Main Duties*
Number of hours worked per week*
Length of service*
Reason for leaving*
Have you ever worked for CECL or an associated company?*

YesNo
If yes which company, location and when?*
Do you have secondary employment?*

YesNo
If YES please give details:
Company
Address
Position Held
Main Duties
Number of hours worked per week?
Referees
References Please list two (2) references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
Position
Phone Number*

Area CodePhone Number
Email
example@example.com
Reference 2
Name:*

First NameLast Name
Position
Phone Number*

Area CodePhone Number
Email
example@example.com
If your application is successful when could you commence employment?
Consent
I blanks consent to the company seeking verbal or written information on a confidential basis about me from representatives of my previous employers and/or referees and authorise the information sought to be released by them to the company for the purpose of ascertaining my suitability for the position for which I am applying. I understand that the information received by the company is supplied in confidence as evaluative and will not be disclosed to me.

This is necessary for compliance with the Privacy Act 1993.
Signature

Clear
General
Are you a smoker?*

YesNo
Do you have any present criminal convictions?*

YesNo
How long ago? (Not including any concealed under the Clean Slate Act)
Have you been subject to Diversion ordered by the court?*

YesNo
Are you awaiting the hearing of charges in a civil or criminal court of law?*

YesNo
Are you prepared to work in a mining environment, including underground projects?*

YesNo
Do you hold a current New Zealand drivers licence?*

YesNo
If YES what class?*
Drivers Licence Number?*
Do you have a spouse, partner, or relative working here or elsewhere in the same industry?*

YesNo
Relevant Trade Certificates

Cancelof
If YES who?
Where?
Medical
If you are offered employment the offer may be subject to you obtaining a full medical clearance (by completion of a medical examination) to assess your fitness for the job for which you are apply.
Do you consent to undergo a Medical Examination?*

YesNo
Do you consent to any biological monitoring in accordance with the Health and Safety in Employment Act 1992 if applicable?*

YesNo
Do you consent to releasing the latest 90 days of your medical and ACC records to our medical practitioner team for review?*

YesNo
Do you have any health-related issues that may impact on your ability to perform the tasks of the position you are applying for? Please disclose all. (for example Hearing loss, Respiratory difficulties, back and/or any other sprains or weakness, fear of enclosed places, visual impairment, Epilepsy or Diabetes) If YES, please detail:*
Privacy Act Consent
Do you consent to the company retaining the information contained in the application form for the purpose of considering your suitability for any other position which may arise with this company in the future?*

YesNo
Declaration
Iblanks (FULL NAME) declare that to the best of my knowledge the information provided in this application form and in my resume enclosed is true and correct. I understand that inaccurate, misleading or untrue statements or knowingly withheld information may result in termination of employment. I understand that this application does not constitute an offer of employment. I understand that, in some cases, police and credit checks will be required and I will be notified if this applies to this application.
Signature

Clear
The completion of this application form does not indicate that there is an obligation on the company to engage the applicant. this information is collected for the purpose of assessing your suitability for employment at Complete Earthworks & Civil Limited which may include subsequent changes in employment with the company.
Resume*

Cancelof
Drivers Licence*

Cancelof
Should be Empty:

Employment Application

Personal Details

Legal Work Status

Education

Additional Information

Employment History

Referees

Consent

General

Medical

Privacy Act Consent

Declaration