Application Form (All fields are required)
1. Advertising Avenue:
Where did you hear about this vacancy?
2. Preferred Name:
What is your preferred name?
3. Salary Expectation:
Please indicate your salary expectation for this position
4. Previous Employment:
Have you ever worked for Selwyn District Council?
5. Work Eligibility :
Do you have eligibility to work in New Zealand?
6. Work Eligibility - further information:
Which best describes your eligibility to work in New Zealand?
7. Referral:
If you have been referred for this position by a Selwyn District Council employee, please provide their full name (they may be entitled to a referral bonus if you are successful). If this doesn't apply, enter N/A.
8. Medical - Pre-existing Conditions:
Do you have any injuries or medical conditions which might adversely affect your regular attendance at work, work performance or the safety of yourself or others?
9. Medical - Medication:
Are you on any medication which may adversely affect your performance in this role?
10. Medical - further information:
If you answered yes to either of the two medical questions above, please provide details below. If you have nothing to disclose, enter 'N/A'.
11. Criminal Convictions :
Have you ever been charged with or convicted of any criminal or civil offence, either in NZ or overseas, or do you have any charges pending?
12. Criminal Convictions - further information:
If you answered yes to the criminal conviction question above, please provide details below. If you have nothing to disclose, enter 'N/A'.
13. Pre-Employment Screening:
If required, do you agree to undergo pre-employment screening such as Ministry of Justice Checks, Police Vetting and Drug and Alcohol testing, at Selwyn District Councils expense?
14. Declaration:
I declare that the information I have provided is true and correct, and I have not omitted to disclose any information which might be relevant to Selwyn District Councils decision to employ me.
I understand if Selwyn District Council later discovers I have supplied any false information or has been misled in any way, including by omission, I will not be accepted for employment, or if I am already employed, my employment may be terminated.
Supplement Documents (Cover letter, etc.)
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