Job Application

Privacy Act Provisions

The information candidates provide in this application for employment will be collected and held by the Gore District Council.

This information is collected for the purpose of assessing a candidate’s suitability for employment within the Council and to meet the Council’s information requirement as a potential employer.

Candidates should understand that they may access personal information about themselves held by the Gore District Council and to seek any correction they think necessary to ensure accuracy. This access to information excludes reference checks undertaken by the Council and all evaluation or opinion material compiled by the Gore District Council for the purpose of assessing suitability, eligibility and qualifications for employment.

NOTE: Candidates should provide complete information in answer to each questions unless otherwise advised, regardless of whether you consider it relevant to the position applied for.

POSITION APPLIED FOR:

PERSONAL INFORMATION:

EDUCATION

EMPLOYMENT HISTORY

Previous employment – start with most recent position and include periods of study if applicable

REFEREES (please complete the consent at the end of this form)

GENERAL EXPERIENCE RELEVANT TO POSITION

LEISURE TIME INTERESTS

GENERAL:

HEALTH

Have you suffered any of the following:

I declare that to the best of my knowledge, the answers to the questions in this application are correct. I understand that if any false information is given or any material fact suppressed, I may not be accepted, or if I am employed, I may be dismissed.

I also understand that any false information given in the medical portion of this form may result in my loss of entitlement for any compensation from ACC.

Gore District Council 29 Bowler Avenue Gore P: 03 209 0330 F: 03 209 0357 E: info@goredc.govt.nz