Te Rau Ora Application Form

Personal Details

Title

General Questions

Are you legally entitled to work in New Zealand? *
Have you previously worked for Te Rau Ora or Te Rau Matatini? *
Do you have a partner, relative or household member working for Te Rau Ora at present? *
Were you referred to this position by a Te Rau Ora employee?

Profile

What type of work are you applying for?
If not full time, what days are you available to work?
Are you willing to travel if required as part of your role? *
Do you have a valid drivers license? *
Are you fluent in Te Reo Māori? *

Job specific questions

Health information
Providing health related information will not exclude you from consideration for this position but will allow Te Rau Ora to consider adapting the job tasks or providing equipment to assist you to carry out the duties of the position, if this is practical and within a reasonable cost.
 
Injury or health condition
Do you live with the effects of any injury or health condition that may affect how you could carry out the duties specified in the position description.
Injury or Health Condition: Please select one of the following options *
Potential conflicts of interest (e.g. secondary employment, voluntary work, relationships, etc)
Please detail below if you have any secondary employment, engaged in voluntary work, or have close relationships (e.g. spouse or partner or family member working for Te Rau Ora.)
 
I declare that, to the best of my knowledge, I do not have any potential conflicts of interest that would affect my ability to remain impartial when carrying out my Te Rau Ora role. I also undertake to inform Te Rau Ora if a potential conflict of interest arises during my employment with Te Rau Ora.
Potential conflict of interest: Please select one of the following options *

Referees

Please list two people that you give permission for us to contact for references. Please ensure that the referees have been notified that a member of the Te Rau Ora Human Resources department will contact them. We usually require referees to be from your Manager/Supervisor in your most recent roles.
Please select one of the following options *

Cover Letter & Resume



Declarations

Background checks
In all dealings, employees of Te Rau Ora must be fair, reasonable and beyond reproach. For this reason, it is vital that all those employed by Te Rau Ora are honest and trustworthy. As part of the standard background checking process we will complete a criminal convictions check through the Ministry of Justice. Criminal conviction checks will be undertaken on the preferred candidate, and these results may not be available until after the commencement of employment.
 
The results from the Ministry of Justice will be checked with you for accuracy.  If at any time prior to your provisional appointment you have not given Te Rau Ora any information that is relevant to the background checks, and/or you have provided any misleading or false information, this may be grounds for dismissal without notice.
 
Criminal records declaration
Criminal Records (Clean Slate) Act 2004
 
The clean slate scheme allows some people the right, in some circumstances, to withhold information about their criminal convictions.  It means that when an eligible person is asked about their criminal record, they can say they have no criminal record.
 
A person must meet all the following conditions.  They must have:
a) No convictions within the last seven years
b) Never been sentenced to a custodial sentence (for example, imprisonment)
c) Never been ordered by a court following a criminal case to be detained in a hospital due to their mental condition, instead of being sentenced
d) Not been convicted of a "specified offence" (for example, sexual offending against children and young people or the mentally impaired)
e) Paid in full any fine, reparation, or costs ordered by the court in a criminal case
f) Never been indefinitely disqualified from driving under section 65 of the Land Transport Act 1998 or any earlier equivalent position
 
If you require further information on the Clean Slate Act please contact the Ministry of Justice.
 
Taking into account the above Clean Slate information:
Convictions: Have you ever been convicted of a criminal offence or serious traffic offence in a civil court? *
Do you have any criminal charges pending? *
Declaration
1) If I am successful in my application, I consent to Te Rau Ora seeking verbal or written information about me from my referees and authorise the release of this information to the panel. This information is provided on the understanding that it is evaluative material based on the terms of Sections 29(1) and 29(3) of the Privacy Act 1993 and will not be disclosed to me unless the referee gives their specific permission.
2) I agree to participate in any medical screening to further determine my suitability for the position applied for, if requested by Te Rau Ora.
3) I understand that if appointed to this position, Te Rau Ora will monitor my health in relation to my exposure to hazards in order to protect my wellbeing in the workplace.
4) I declare to the best of my knowledge the information in this application and my Resume/Curriculum Vitae is correct and I understand that if I give any false or deliberately misleading information, or suppress any material fact in the recruitment process, I may not be accepted or employed, or if I am employed, my employment may be terminated.
Declaration: Please select one of the following options *