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The Application Form is a source of information which will be used to assist your
prospective employer in considering your suitability for the position for which you are
applying. If successful, this information will form part of the personnel records. Failure
to supply the information requested could prejudice the employer’s ability to assess
your suitability for the position.
You are entitled to access this information upon request to the employer’s Privacy
Officer.
Why not sign up for our breaking news alerts and labour market reports?
Ask your consultant to sign you up to news alerts and labour market. This will alert
you to any updates that we have on industry remuneration/wage rates, our monthly
labour market report, and topics of interest in New Zealand’s motor industry.
Let us do the work and send you the jobs directly to your email. It is easy to edit your
alerts any time you wish, for example, if you wish to add or subtract categories.
You can get your consultant to sign you up for job alerts. We can then assist you in
choosing the relevant job categories while you are here. You can also do so yourself
at a later stage online at www.automotiveemployment.co.nz. You will find the Job
Alerts registration button on the Home page.
Would you like to sign up for our candidate newsletter outlining recent changes in the industry? Yes No
Would you like to receive job alerts for vacancies in your category? Yes No
DRIVERS LICENCE
Do you have a current drivers licence? Yes
No
If yes, what Classes? ___________B_________
Drivers Licence No.__________044650__________ Sighted by: ___CYPRUS
POLICE_______________ Consultant’s Signature
Do you have any demerit points or endorsements? Yes
No
If yes, please
detail___________________NO________________________________________________
_______
Have you had your Licence suspended or cancelled in the last 5 years? Yes
No
If yes, please
detail_______________________________________NP_____________________________
______
RESIDENT STATUS
Are you a citizen of New Zealand? Yes
No NONO
Are you allergic to, or have any sensitivity to any substances or chemicals? Yes No
Is your eyesight normal? Yes No
Do you require corrective lenses or contact lenses? Yes No
Have you ever suffered from a back injury requiring time off work? Yes No
If yes, please
detail__________________________________________________NO________________________
_________________________________________________________________________________________
Do you have any other condition which may affect your ability to effectively carry out the functions and
For the purpose of Immigration processing, do you have any known medical conditions? Yes No
Approximately how many days have you been absent from work in the last 12 months (other than for annual
leave).
___________________________________________________________NO________________________
1. I CERTIFY that all information provided about me to you is true, accurate and complete.
2. I UNDERSTAND that all information provided about me to you will be held by you and used for the
purpose of evaluating my qualifications, experience and suitability for permanent and/or
temporary employment with you or with any other employer.
Should I be successful in my application for permanent employment, I request Automotive
Employment NZ Ltd to retain information provided by me for a period of 5 years for the purposes
of retaining accurate employer client records.
3. I AUTHORISE you to contact any person and seek further information from them which may be
relevant to my application for employment.
4. I AUTHORISE you to disclose information which you hold about me to any potential employer.
5. I UNDERSTAND that if I withhold any relevant information my application may not be further
considered. I also understand that my employment may be terminated if after investigation, an
employer discovers that any information which I have provided is false or misleading.
6. I AUTHORISE you to promote my availability to potential employers through web site and email
promotions via an anonymous listing of my qualifications and experience.*
7. Are you currently being represented by any other Recruitment Agency – If yes, which
Agency___________________________________________________________________________
8. I AUTHORISE you to retain any information about me until I advise you that I no longer wish to
seek employment opportunities through you and that I wish you to delete or destroy that
information. I understand that you might retain non-active information about me on your
computer system, unless I request you to destroy that information. I understand that all payroll
information will be retained for the statutory period of at least 7 years. I further understand that
you might retain non active information about me on your computer system unless I request you
to destroy or delete that information.
9. Do you have any family members or friends in a role with a competing company that would
cause a conflict of interest in connection with the role/s that you are applying for? Yes No
10. Specifically authorised reference providers are as follows:
0035797634675
Automotive Employment NZ Ltd will take reasonable precautions in accordance with the Privacy Act 1993 to safeguard
your personal information against loss, misuse or unauthorised use or disclosure. Personal information held by
Automotive Employment NZ Ltd about you can be accessed by you, and you have the right to request correction of that
information, in accordance with the Privacy Act 1993.