PERSONAL DETAILS

ALL APPLICANTS TO COMPLETE

Note: Taratahi reserves the right to use any relevant employment related information that it might hold about you as an employee when assessing your suitability for the position you are applying for.

HEALTH & SAFETY

The following information is required to assist Taratahi to meet its obligations under the Health & Safety in Employment Act 1992 and subsequent amendments and the Injury Prevention Rehabilitation and Compensation Act 2001, and to assess your ability to perform the duties of the position safely.

It is important that you let us know of any health issues or disability that you have that is relevant to the role you are applying for. If you require special services or facilities, and it is reasonable for Taratahi to supply these, then we will work to accommodate you. Letting us know that you have a medical condition or disability will not exclude you from being considered for the position.

Do you suffer from or have you suffered from any injury or medical condition caused by gradual process, disease or infection (e.g. gradual process injury, back injury or strain, hearing loss, sensitivity to chemicals) which the tasks of this job as listed in the job description may aggravate or contribute to?

Have you any other injury or medical condition which may affect your ability to effectively and safely carry out the functions and responsibilities of this position?

REFEREES

Please provide the names and contact details of two referees whose consent has been obtained and who may be contacted for a confidential reference. (Where possible at least two of these referees should be previous employers and have supervised or been senior to you in your current or most recent employment). STAR (*) those references that you do not wish us to contact at this time.

CRIMINAL OFFENCES

As an educational institution those working within Taratahi Agricultural Training Centre are placed in positions of trust. Taratahi therefore requests that you answer the following questions:

Have you been convicted or discharged without conviction as a result of criminal charges in New Zealand (excluding those convictions protected from disclosure by the Criminal Records [Clean Slate] Act 2004) or any other country?

Are there any charges pending against you?

DECLARATION

I declare the above information and any attachments that I have provided to Taratahi Agricultural Training Centre in applying for this position are complete, accurate and correct, and I have not omitted any information that would affect the decision to employ me.

I understand that if I am successful in my application and it is subsequently discovered that information I have provided is not complete, accurate and correct or I have failed to disclose information, my employment may be terminated.

Please do not send folders or original documents. Documents will not be returned.

Should Taratahi wish to offer you the position, a formal, written letter of offer will follow any verbal discussion. Any agreements will only be binding on the employer where they have been formally offered by the Chief Executive Officer and accepted by the employee.