Pre Employment Declaration Step 1 of 911%Please complete all sections. Information you share will be dealt with in accordance with the privacy and data protection policies set out on our website. It may also be used to determine your suitability for employment with our clients.Name* First Last Email* Enter Email Confirm Email Nationality*Are you a New Zealand citizen?YesNoNon-Citizens*If you are not a New Zealand citizen, do you have a valid visa that entitles you to legally work in New Zealand?YesNoNZ Visa*What NZ visa do you have?SelectNZ ResidencyNZ Permanent ResidentNZ Essential Skills Work VisaNZ Talent (Accredited Employer) Work VisaNZ Work VisaNZ Working Holiday VisaOtherPlease provide further details* Police Check*Do you consent to us undertaking a Police Check in New Zealand?YesNoPolice Clearance*Do you have a current Police Clearance certificate from your country of origin?YesNoPolice Clearance Expiry DateWhat date does your Police Clearance expire? Date Format: DD dash MM dash YYYY Police Clearance CertificateIf available, please upload a copy of your Police Clearance certificate in PDF/JPEG/PNG format. Drop files here or Accepted file types: pdf, jpg, png.Convictions*Have you been convicted of any offence against the law in any country, or do you have criminal charges pending, apart from minor offences that meet the eligibility criteria for the Criminal Records (Clean Slate) Legislation in New Zealand?YesNoPlease provide further details* Health*Do you currently have, or have you ever had an injury, illness, disease, infection, medical condition or disability caused by a gradual process (e.g. hearing loss, OOS) or other health condition, which could contribute to, aggravate or affect your ability to undertake work?YesNoPlease provide further details*Please provide details of an injury, illness, disease, infection, medical condition or disability that may affect your ability to perform work duties.Accommodating Needs*Please advise practical ways in which a prospective employer could reasonably accommodate any special needs in relation to your illness, injury or disability.Medical Assessments*Do you consent to a medical assessment by a qualified medical professional to determine your ability to perform duties required in a role?YesNoSharing Your Medical Assessment Report*Do you consent to your medical assessment results being shared with a prospective employer for the purpose of determining your ability to perform the role?YesNoDrug Testing*To maintain safe and healthy workplaces, employers may carry out both random and periodic drug and alcohol testing. Do you consent to being drug tested?YesNo Professional Qualifications*Do you consent to us verifying your academic qualifications and/or professional membership status?YesNo Credit History*Do you have a clean and clear credit history?YesNoPlease provide further details* Employee Conduct*Have you ever had a formal dispute/grievance with a previous employer?YesNoPlease provide further details*Employee Conduct Continued*Have you ever been terminated from previous employment?YesNoPlease provide further details* Other ApplicationsHave you applied for any jobs in New Zealand in the last six months?YesNoPlease provide further detailsPlease list all of the places you have previously applied to (over the last six months).This will help us ensure that we don't accidentally recommend you to somewhere you have already approached. Authority and Declaration, Privacy Act 1993*Authority and Declaration I authorise Hanzon Jobs to collect personal information about me from referees provided by me as is necessary to assess my suitability for employment. I authorise Hanzon Jobs to disclose such personal information as is necessary for the same purpose. I also authorise the referees holding such information about me to disclose that information to Hanzon Jobs for the same purpose. I declare that I have read the below Privacy Act statement and I am aware of my rights under the Privacy Act 1993. I certify that the information provided is true and correct and no information has been omitted. I understand that any incorrect, misleading or omitted information may disqualify me for appointment through Hanzon Jobs, or if I am appointed, make me liable for dismissal. I authorise Hanzon Jobs to use the information that I have provided, should I be appointed, for any claims under the Injury Prevention, Rehabilitation and Compensation Act 2001, the Human Rights Act 1993 and the Health and Safety in Employment Act 1992 and Amendment 2003. I authorise that any information I receive from Hanzon Jobs or from any Hanzon Jobs client relating to any employment opportunity, or prospective employment opportunity, will remain confidential and will not be passed to any third parties. I will not use this information to seek employment, either personally or through another party from any Hanzon Jobs client unless it has previously been agreed by Hanzon Jobs. If I decline interest in any employment opportunity presented to me by Hanzon Jobs, I will not pursue the aforesaid opportunity directly or through any other third party for a period of six months after it was presented to me by Hanzon Jobs. Privacy Act 1993 The information you supply on this form is used to assess your suitability for employment with Hanzon Jobs’ clients or associate recruitment consultancies. This information will be retained and disclosed to a third party, prospective employer or associate recruitment consultancy only with your authorisation or where it is required by law. Information on unsuccessful professionals will be kept confidential and will be destroyed after three months. You have the right to view your personal information held by Hanzon Jobs and may request for it to be corrected if necessary. Failure to complete all sections of this form truthfully and completely may lead to Hanzon Jobs withdrawing registration or any applicable contract for service. Yes, I agreeDate Completed* Date Format: DD dot MM dot YYYY CommentsThis field is for validation purposes and should be left unchanged.