APPLICATION for Employment

PERSONAL DETAILS

RIGHT TO WORK

Are you a NEW ZEALAND CITIZEN

yes no

I have RESIDENCY or a WORK VISA:

yes no

and I want to ATTACH a copy of my PASSPORT and I want to ATTACH a copy of my BIRTH CERTIFICATE and I want to ATTACH a copy of my LETTER OF CITIZENSHIP

Upload copy of birth certificate

Upload copy of Letter of citizenship

and I want to ATTACH evidence of my RESIDENCY and I want to ATTACH evidence of my WORK VISA and I want to ATTACH a copy of my PASSPORT

Upload copy of evidence of residency

Expiry Date of WORK VISA

Upload copy of evidence of work visa

Upload copy of passport

DRIVERS LICENCE

Do you hold a current New Zealand Drivers Licence?

yes no

Do you hold a valid Forklift Licence?

yes no

Have you ever been disqualified from driving?

yes no I am aware that a copy of my drivers licence will be held and permission is given for my details to be entered into the NZTA database.

SECURITY CHECK

Have you ever been convicted of a criminal offence?

yes no

All criminal convictions must be disclosed unless covered by the Criminal Records Clean Slate Act 2004. If you are unsure whether or not a past conviction is covered by the Criminal Records Clean Slate Act 2004 please visit http://www.justice.govt.nz/services/criminal-records Failure to disclose any convictions not covered by the Clean Slate Act 2004 may result in the withdrawal of any offer of employment.

I acknowledge that MOVE Logistics has the right to conduct a Security/Police check on me. I acknowledge that if my application is successful MOVE Logistics may geo-fence my home address in their GPS system for security purposes, for the duration of my employment.

EMPLOYMENT HISTORY

Please provide details on your previous two positions (the two most recent two jobs you have held).

Company 1

Company 2

Have you worked for MOVE previously (including as a temp)?

yes no

Have you worked for one of MOVE’s customers previously?

yes no

MEDICAL HISTORY

Do you have any known medical condition or old injury that may affect your ability to carry out your work?

yes no

Have you suffered a significant illness or injury requiring you to take significant time off work or claim ACC?

yes no

Do you wear glasses or contact lenses?

yes no

Please tick if you have suffered from any of the following conditions:

Back strains/injuries High blood pressure Conditions Heart complaints Conditions Asthma Conditions Diabetes Conditions Hearing loss Conditions Hernia Conditions Black outs/seizures/fits Conditions Allergies

DECLARATION

I acknowledge that MOVE Logistics may enquire with the Accident Compensation Corporation (ACC) regarding my claim history.

I acknowledge that MOVE Logistics may enquire with the Accident Compensation Corporation (ACC) regarding my claim history.

I declare that to the best of my knowledge, the answers given in this application are correct. I understand that false information is grounds for application being declined or my employment being terminated if appointed.

I have read and fully understood this declaration.