Please complete all of the following details-applications are only accepted online for employment between December and May:

First Name			NZ Citizen	-YN
Last Name			Date of Birth
Street Address			Place of Birth
City			Country of Birth	AfghanistanAmerican SamoaArgentinaAustraliaBangladeshBelarusCanadaCentral African RepublicChileChinaColombiaCook IslandsEcuadorEgyptEuropean UnionIndiaIndonesiaJamaicaNew ZealandRussiaSamoaTahiti French PolynesiaThailandTokelauTongaUnited KingdomUnited StatesVanuatu
Zip/Postal Code
Country			Passport Number please if NOT a NZ citizen
E-mail			Passport No
Contact Phone			NZ Student

IRD Number(9digit)     Bank A/c (16digit)

Do you suffer skin infections (dermatitis/excema)?	-YN		Have you had compensation for any injury?	-YN
Have you had back strain or injury?	-YN		Have you been dismissed from a previous job?	-YN
Do you suffer high blood pressure?	-YN		Have you brought a grievance against an employer?	-YN
Do you suffer a hearing complaint?	-YN		Have you been convicted for theft/drugs?	-YN
Do you suffer colour blindness?	-YN		Do you use/carry illegal drugs?	-YN
Any other medical conditions?	-YN		Have you any other convictions?	-YN
Can you work for 5½ days per week (Feb-May)?	-YN		Do you have adequate child minding arrangements?	-YNNA
Contact person (name/tel) in case of illness?

I hold a current work permit for this employment.	NAYN		I hold a visitor/student permit for this employment.	NAYN
My Gender is (IAmA)	FemaleMale		I can begin work	NowNext WeekOther
Other employment entitlement (specify)

Previous Employer's Name.			Period Employed.	-less than 1 week1 to 4 weeks4 to 8 weeks8 to 16 weeks16 to 52 weeksmore than 1 yearStudy-School StudentStudy-University/Otherother
Previous 24 month employment details.			Previous Experience	-Packhouse GraderPackhouse PackerPackhouse Forklift operatorPackhouse Glue/Stack/StrapPackhouse Document ClerkPackhouse QCPackhouse DrenchOrchard Harvest-LadderOrchard Harvest-GroundOrchard Harvest QCOrchard Harvest ForkliftOrchard Harvest SupervisorHydralada operatorOrchard PruningOrchard ThinningNilOther
			I am applying for a position via	WINZSSESJSAdvertReferralFriendWalk-InOtherJosOrSally-
Transport to Worksite	My Own VehicleRiding with a FriendI DO NOT HAVE TRANSPORT		I have been Vaccinated for Covid19	NOT VACCINATEDFIRST JabSECOND JabI HAVE A VACCINE PASS

	By submitting this application form you agree to work as directed and declare that you are entitled to be employed in New Zealand. You acknowledge that the employer has the right to determine your eligibility to work in New Zealand and can require proof to confirm your status. This completed application does not constitute an offer for employment. Your further acknowledge that you will observe personal hygiene habits consistent with best practice food safety and that you are not currently suffering from any communicable disease or infection. Thank you for your interest in working with us.