WORK WITH US

Date
MM slash DD slash YYYY
Preferred Store - 1st choice*
Preferred Store - 2 nd choice
Position applied for
Personal Information
Full Name*
Age*
Date of birth*

Day
Month
Year
Email address*
Phone number*
Surburb where you live*
GENERAL AVAILABILITY -Specify if you are free weekdays day/night and or weekend day/nights.
Date you are available to start?
MM slash DD slash YYYY
Citizenship*
If not a New Zealand citizen, what type of visa have you been issued with?
Other Information About You
What are your hobbies and interests?
What languages can you speak?
Do you have any health issues we should know about?*
Education and / or Relevant Courses (list up to 3)

List*

Name Of School/Tertiary Institution	From	To	Level Achieved

List

Name of Employer	From	To	Type Of Business	Position Held	Person reported to

References: (personal references if work references are not available)
(personal references if work references are not available)

Name	Contact Number or Email	Relationship

WANT US TO SEE YOU? Upload your photo of yourself or video of why you want the job here
Drop files here or

Accepted file types: jpg, pdf, png, mp4, avi, Max. file size: 2 GB, Max. files: 2.
ANY MORE ABOUT YOU ? Is there any additional information you would like to provide in support of your application?
Disclaimer
In creating this application I affirm that the preceding statements are true to the best of my knowledge, & any misrepresentation of facts or material omission thereof shall be cause for dismissal. I give permission to perform any reference checking that may be relevant to this position.
- Yes

Personal Information