Application Form
(All fields are required)
1. Advertising avenue:
Where did you see this role advertised?
2. Residency status:
Which option best describes your current residency status?
3. Immigration Check:
Part of our employment process is to undertake an immigration check. Do you give consent for this?
4. Qualifications:
Do you have a New Zealand Certificate Level 2 (or above) in Health and Wellbeing?
5. Experience:
How many years of experience do you have working as a Community Support Worker?
6. Sector Experience:
How many years of experience do you hold working within the Disability Sector?
7. Salary:
Please indicate what hourly rate you would expect for this role.
8. Conflict of Interest:
If offered this position, will you be voluntarily engaged in any other employment/position that may cause a conflict of interest with CCS Disability Action? If so, please outline below.
9. Police Check:
Part of our employment process is to undertake a full police check, and appointment is subject to a satisfactory outcome. Do you give consent for this?
10. Criminal Convictions:
Do you have any criminal convictions including any concealed under the Criminal Records (Clean slate) Act? If yes, please detail below.
11. Drivers Licence:
Which type of drivers licence do you possess?
12. Medical Conditions / Injuries:
Under the Health and Safety at Work Act 2015, we must ask do you suffer from or have you suffered any injury or medical condition, that may impact you doing this job? If yes, are there any specific supports, equipment or assistance we can provide to allow you to perform this job? If yes, please detail.
13. Information Obtained:
Do you give consent for CCS Disability Action to use your information to assess your suitability for other position vacancies that may arise within the next 6 months?
14. Availability:
Please indicate the days you would be available.
15. Commencement:
If offered the role, when will you be able to commence employment?
16. Declaration:
Do you consent to CCS Disability Action seeking verbal or written information from the referees? I hereby certify that all the information given for my application is complete, true and correct.
17. Location:
Do you currently reside in New Zealand?
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