Nurses Home Application - Part Time Roles

  • Employment Application

    Fill the form below accurately indicating your potentials and suitability to job applying for.

  • Personal Details

  • Legal Work Status

  • Job Skills & Training

  • Additional Information

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

  • Employment History

  • Present or Most Recent Employer

  • For the purposes of compliance with the Privacy Act 1993 do you consent to the company contacting your present employer?*

  • Next Most Recent Emplolyer

  • Have you ever worked for Alton Drilling or an associated company?*
  • Do you have secondary employment?*

  • If YES please give details below:

  • Referees

  • References  Please list two (2) references that are familiar with your work life.
  • Reference 1
  •  -
  • Reference 2
  •  -

  • Consent

  • I 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.

  • General

  • Are you a smoker?*
  • Do you have any present criminal convictions?*
  • Have you been subject to Diversion ordered by the court?*
  • Are you awaiting the hearing of charges in a civil or criminal court of law?*
  • Are you prepared to handle all products, materials, or equipment used in there industry?*
  • Do you hold a current New Zealand drivers licence?*
  • Do you have a spouse, partner, or relative working here or elsewhere in the same industry?*
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  • 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?*
  • Do you consent to any biological monitoring in accordance with the Health and Safety in Employment Act 1992 if applicable?*
  • Do you consent to releasing the latest 90 days of your medical and ACC records to our medical practitioner team for review?*

  • 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?*

  • Declaration

  • I (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.

  • 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 Alton Drilling Limited which may include subsequent changes in employment with the company.

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