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Application Form

Please fill in this form and attach your CV and any other material you consider relevent. An attachment can only be a word file or a PDF document.

This form and any other material you provide with it, is a source of information which will be used in considering your suitability for the position for which you are applying. Failure to supply the information requested may prejudice our ability to assess your suitability.

Your Details

Position
Vacancy Number
Name
Address
Day Time Phone
Mobile
Fax
Email

Referees

Names of two or three referees whose consent has been obtained and who may be contacted for confidential reference. (Where possible at least two of the referees should be able to give work related information and should have supervised or been senior to you in your current or most recent employment)

First Referee

 Name
Address
Phone
Mobile
Email

 

Second Referee

 Name
Address
Phone
Mobile
Email

 

Third Referee

 Name
Address
Phone
Mobile
Email

Work Entitlement

Please give the date you are available to start or the period of notice required in your current employment.

Date Available
Notice Required


Are you legally entitled to work in New Zealand?

Do you consent The Omnia Group® Ltd retaining the information obtained in relation to this application for the purpose of assessing your suitability for other positions for which you may be considered within the next six months.

As part of our pre-employment process you are required to undertake a full medical assessment which will include testing for banned drugs. Do you consent to this?

Do you have any other business interests that may conflict with the position for which you are applying?

Convictions

Have you had any convictions for criminal offences other than minor driving infringements?

Have you ever been disqualified from driving?

If Yes, Please Give Details


Are you awaiting any court appearances?

Have you ever been disciplined or dimissed from employment for any of the following?

Have you ever had your name changed by statuary declaration?

Supporting Files

Please attach your CV and/or supporting documents here.
Click on the BROWSE button to select a file on your local computer. Word or Adobe Acrobat files (PDF) are accepted.
First
Second
Third

Declaration

I consent to Omnia seeking verbal or written information about me on a confidential basis and authorise the information requested to be released. I understand that the information will be supplied in confidence as evaluative material and will not be disclosed to me.

I understand Omnia uses Baycorp Advantage to seek information on me.

I hereby certify that all the information given orally and in writing by me for my application is true and complete to the best of my knowledge and belief. I understand that the provision of false, incomplete or misleading information will be grounds for summery dismissal.