Applying with us is very easy

Simply complete your personal details below, then answer our questionnaire which is specific to this vacancy. Your answers to the questionnaire will enable us to process your application faster. At the very bottom of this page please upload your resume and a covering letter or supporting documents if relevant. We accept files in PDF, .doc or .docx formats, under 2MB.

First Name

Last Name

Address 1

Country

State/Region

City/Suburb

Postcode

Mobile

A/H Phone

Confirm Email

Application Form (All fields are required)

1. Advertising Avenue:

Where did you see this role advertised?

wairarapadhbjobs.co.nz

Trademe

Seek

Facebook

Kiwihealthjobs.com

Te Pou

The Werry Centre

Social Media

Other

Word of Mouth

Internal Advertising

2. Ethnicity :

Please indicate the ethnic group you most identify with from the selection below. This information is gathered for statistical purposes only.

New Zealand European

Maori

Samoan

Cook Island Maori

Tongan

Niuean

Chinese

Indian

Other

Prefer not to answer

3. Ethnicity - Other:

If you answered "Other" to the above question please write what ethnic group you identify as below. If you have already stated your ethnicity above please write "n/a" to proceed.

4. Qualification:

Do you meet the essential qualifications as mentioned in the position description (if applicable, including the requirement to hold a current APC)?

YES

5. APC:

Do you have any restrictions on your APC?

YES

N/A

6. Experience:

Do you meet the essential experience required for this role as mentioned in the position description?

YES

7. Skills & Expertise:

Do you meet the essential skills as mentioned in the position description?

YES

8. New Zealand Residency:

Do you have permanent residency in New Zealand?

Yes

9. Working authority in New Zealand:

Are you legally authorised to work in New Zealand?

YES

10. Criminal Offences:

Have you ever been charged with or convicted of a criminal offence or released from prison?

YES

11. Criminal Offences:

If "Yes", give brief details (or if "No" to the above question please enter "n/a" to this question):

12. Disclosure Statement:

Do you consent to the disclosure to Te Whatu Ora Wairarapa of whether you have been subject to a serious misconduct investigation, either concluded and upheld or currently under investigation, from all previous Public Service and statutory Crown entity employers for the last three years? This will usually be conducted at the preferred candidate stage.

YES

I would like to discuss this before it is undertaken

13. Subject of a Complaint:

Have you been the subject of a complaint to your professional body or the Health and Disability Commissioner? Please state either "No", or if "Yes", please give brief details:

14. Conditions that may affect personal ability:

Do you have any condition that may affect your ability to effectively carry out the functions and responsibilities of the position you are applying for. Please state either "No", or if "Yes", give brief details:

15. Declaration:

I declare that all the information given above is correct, and I give permission for my referees to be contacted. I understand that I may be required to supply originals of any relevant documents supporting this application.

YES