To be completed personally by applicant

Please read this information carefully. It will help you complete your application and ensure you provide us with all the information we need to process your application. Applications must be submitted electronically using the link provided. Supporting material should be relevant to the position applied for and all material will be treated as confidential.

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* 1. Application for Employment
(Note: there is an additional space to include further notes at the end of this application if needed)

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* 2. Contact Details - all fields require an answer.

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* 3. Date of Birth:

Date

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* 4. If your application is successful, when could you commence employment?

Date

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* 5. Present or Most Recent Employer

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* 6. Are you currently employed as a reliever by any other organisation?

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* 7. NZ Post School Qualifications - please confirm by completing the name of the Teaching Institution and Date, Month and Year Attained

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* 8. Add all other New Zealand and Overseas Tertiary qualifications and any NZQA statements of Recognition here:

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* 9. I declare that I, the applicant, have listed all New Zealand and Overseas Tertiary Qualifications and NZQA Statements of  Recognition that I currently hold.

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* 10. You will require a current First Aid Certificate

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* 11. Teacher Registration

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* 12. As we are part of the State Sector we must furnish annual EEO information to the Ministry of Education MOE.  This information is purely statistical and individual names are not furnished.  By providing this information you will not be disadvantaged in any way.

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* 13. EEO Statistics only:
Please indicate from the MOE list below which ethnicity group you identify with:

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* 14. Entitlement to Work
I am entitled under the Immigration Act 2009 to undertake work for the Waikato Kindergarten Association/Early Education Waikato.
Please tick the box that applies. (Note: You will need to provide evidence regarding your entitlement to work if approved for this position).

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* 15. Comment if you need to add anything further.

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* 16. Have you ever been dismissed or resigned during an investigation by a previous employer for anything involving dishonesty, misrepresentation, theft, fraud, breaching policies, performance concerns or any other form of misconduct?

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* 17. Do you have any criminal convictions (other than those you are allowed to conceal under the Criminal Records Clean Slate Act)?

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* 18. Have you ever received diversion under the New Zealand Police diversion scheme?

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* 19. Are you currently subject to any criminal investigation or pending charges?

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* 20. Have you ever been implicated in any instance or, accused of being unsafe around children?

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* 21. Have you had, or do you have, any known health condition, injury or illness of any kind, which may be aggravated and/or affect your ability to effectively carry out the functions and responsibilities of the position applied for?

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* 22. ii) may be aggravated or further contributed to by undertaking the tasks of the position applied for?

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* 23. Are you receiving any medical treatment or taking any medication/drugs/injections (prescribed or otherwise) which could possibly affect your performance or safety, or the safety of others?

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* 24. Have you ever been reported to the Teachers Council?

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* 25. Any Additional information you would like to add.

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* 26. I consent to the Waikato Kindergarten Association/Early Education Waikato seeking verbal or written information on a confidential basis about me from my named referees. 
I authorise the information sought to be released by them for the purposes of ascertaining my suitability for the position for which I am applying.
I understand that the information received is supplied in confidence as evaluative material and will not be disclosed to me.
Referee One:

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* 27. Referee Two:

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* 28. Attach your CV to support your application.

PDF, DOC, DOCX file types only.
Choose File

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* 29. Attach any additional documentation you would like to provide

PDF, DOCX, DOC file types only.
Choose File

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* 30. Additional documentation ie. Residence permit, First Aid Certificate

PDF, DOC, DOCX file types only.
Choose File

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* 31. Declaration
 In submitting this application, I declare that all the information provided in this application and in any CV or other documentation provided by me is true and accurate. 

 I understand that if any false or misleading documentation is given or if any material fact suppressed, I may not be employed, or if I am employed, my employment may be terminated. 

I also understand that any false information given in relation to my medical history with regards to gradual process, disease or infection can result in my loss of entitlement for any compensation from ACC. 

I understand if I am the successful applicant for this position, the interview schedule (including interview notes and reference checks) will be held securely and confidentially by the Waikato Kindergarten Association.

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