APPLICATION FOR EMPLOYMENT FORM FOR FIELD STAFF POSITIONS

Thank you for your interest in wanting to work for Prolife Foods. Please complete this Application for Employment yourself.  It is desirable that you also email your current Curriculum Vitae to recruitment@prolife.co.nz along with any other relevant documents that you believe would support your application.  Please do not include any original documents.  

This application form is a source of information which will be used to assist us in considering your suitability for the position for which you are applying.  Thank you for taking time to complete the form.

PERSONAL DETAILS *
PERSONAL DETAILS
Are you known by any other name? If Yes, what other names are you known by?
Are you known by any other name? If Yes, what other names are you known by?
Home Phone
Home Phone
Work Phone
Work Phone
Mobile Phone *
Mobile Phone
LEGAL WORK STATUS
Are you a New Zealand Citizen? *
If yes, can you produce evidence if required?
If no, do you have the right of permanent residence or a work permit? (It will be necessary to produce your passport and associated documentation for verification)
EDUCATION/QUALIFICATIONS:
EMPLOYMENT HISTORY:
Current or most recent employment
EMPLOYMENT HISTORY:
Next, most recent employment
MEDICAL
IF YES PLEASE DETAIL:
IF YES PLEASE DETAIL:
Are you a smoker?
Do you have any allergies/intolerances that we should be aware of? (e.g. peanuts, other nuts, food allergies, aversion to heights, etc)
Have you had any previous injury or medical history in the last 10 years?
Have you had any previous back problems?
In your previous employment have you been exposed to:
Do you agree to undergo a full medical examination (including a test for class A, B or C drugs)?
Do you wear contact lenses?
GENERAL QUESTIONS
Are you prepared to work shifts if required to do so?
Have you worked shifts before?
Are you prepared to work overtime if required?
Have you ever been convicted, diverted or convicted and discharged in relation to any criminal offences?
Are you awaiting the hearing of charges in a civil or criminal court of law?
Do you agree to police disclosure being sought?
Have you had a formal warning from a previous employer?
Have you ever been dismissed from previous employment?
Have you ever been banned from Foodstuffs or Progressive store?
Have you ever been made redundant from previous employment?
Do you own a smart phone for payroll – clocking in/out purposes?
Do you have a spouse, partner, relative or household member working here or elsewhere in the industry?
Are you prepared to handle all products, materials and equipment used in the industry?
Do you have a current New Zealand driver’s licence?(copy attached)
Licence type
Any demerit points
Has your licence ever been endorsed?
Are you a member of any territorial force unit?
If so, have you completed the whole time training?
Do you consent to the Company retaining the information contained in your application for the purposes of considering your suitability for any other position that may arise in the future?
REFEREES
Please provide the names and contact phone numbers (daytime, and if possible, after hours) of at least four (2) recent work related referees, where there has been a direct relationship: (i.e. managers that you have reported to, colleagues that you have worked with and the staff you have managed).
At least 4 names and your relationship with them (i.e. managers, colleagues or staff)
I consent to Prolife Foods Limited seeking verbal or written information on a confidential basis about me from the above referees, and I authorise these referees to release information to Prolife Foods Limited for the purposes of ascertaining my suitability for this position. *
DECLARATION
I declare that, to the best of my knowledge, the details given in this application form are accurate and correct and I understand that if any false or deliberately misleading information is given, or any material fact suppressed, my application will not be accepted, or if I am employed, my employment will be terminated. *