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Application Form

Thank you for your interest in applying for one of the vacancies with GoBus.

Please fill out the below details and attach an up to date copy your CV.

Vacancy Details
Position
Vacancy Reference Number


Full Name
Contact Address
Email Address
Phone Number(s):
Home
Mobile

General Details (please tick as applicable)

Are you legally entitled to work in New Zealand? Yes No
Have you ever had a driving offence, including speeding or drink driving offences? Yes No
Do you currently have any demerit points on your licence? Yes No
Have you ever been convicted of a criminal offence?
(if yes, please provide details under "Any Other Information")		 Yes No
Note: The "Clean Slate" Act does not apply to some specified offences (i.e: certain sexual offences) and you should declare any such offences when answering this question.

Are you awaiting the hearing of charges in a civil or criminal court of law? (if yes, please provide details under "Any Other Information") Yes No
Have you ever had your drivers' licence cancelled or suspended?
(if yes, please provide details under "Any Other Information")		 Yes No
Note: The "Clean Slate" Act does not apply to any indefinite disqualification from driving under section 65 of Land Transport Act 1998.

Have you previously worked for Go-Bus or any company purchased by Go-Bus? Yes No

Drivers' Licence Details (please tick as applicable)

Do you have a current full driver's licence? Yes No

Drivers' Licence Number
Licence Expiry
Class of Licence Held
If Car Only, How Long Held Full Car Licence? (years)
Licence Endorsements

Health (please tick appropriate box)

Have you any medical condition or pre-existing injury that may be aggravated or further contributed to by tasks of this position, or which may affect your ability to perform the job for which you are applying? Yes No

If yes, please provide details and advice on how we may be able to accommodate you:

Do you agree to undergo a medical examination if required? Yes No

Work History (please provide details on your most recent work histroy.
Employer
Address
Position Held
Dates


Employer
Address
Position Held
Dates


Employer
Address
Position Held
Dates

Referees (please provide details of two referees who are in a position to comment on your work.
Name
Address
Relationship
Contact Phone Number


Name
Address
Relationship
Contact Phone Number


Name
Address
Relationship
Contact Phone Number

Availability (please tick as applicable)

Are you available to work shifts (including mornings and/or evenings)? Yes No
Are you available to work on a casual/on call basis? Yes No
Are you available to work part-time? Yes No
Are you available to work weekends? Yes No
Are there any days/times you can not work? Yes No

Please specify

Any Other Information
Are there any other issues or information you wish to mention relevant to this application such as the reasons for your application or any non-work interests and skills?

Attachment of Documents
Curriculum Vitae

Personal Information - The Privacy Act 1993

I understand that this information is sought for the purpose of being considered for a position with the company and will be accessed by those responsible for the recruitment and management within Go-Bus (including management and payroll personnel), but will not to be provided to any third party without my prior agreement.


The information supplied by you will be retained by Go-Bus if you are appointed to a position. If you are not appointed to a position at Go-Bus, the information will be destroyed after 12 months.

I understand that under the Privacy Act 1993 l have the right to access personal information held about me and to seek any correction that l think necessary to ensure accuracy. Enquiries regarding retained information should be directed to the Company's offices at 57 Higgins Road, Hamilton, Attention: Chief Operations Officer.

Declaration and Authority

I declare that I have completed all sections of this application truthfully. I understand that if I am successful in this application that providing incorrect, false or misleading information may be grounds for the termination of my employment.


I understand that if successful my drivers licence details will be placed on the NZTA Driver Check system - TORO.


I agree that Go-Bus can contact the above named referees seeking verbal or written information about me but that my current employer will not be contacted without my prior express consent. I also agree Go-Bus may verify my CV details.

I agree that Go-Bus may obtain information about me from the Ministry of Justice in relation to this application.


I agree that Go-Bus may obtain information about me from the NZTA in relation to this application


I confirm that I have read and understood the section in this application headed 'Personal Information - The Privacy Act 1993'.

Name
Date


Waikato Bay of Plenty Manawatu Gisborne Hawke's Bay Christchurch
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