Employment Webforms

Note

New employees please complete:

Employee Information
Medical Questionnaire
Employment Contract

All must be completed and returned to office before you can start work.

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Employee Information

Start Date

YYYY

Name *

Name

First Name

Last Name

Address

Phone

Date of Birth

DD/MM/YYYY

Drivers Licence Number

Driver Licence Expiry Date

DD/MM/YYYY

Email Address

NEXT OF KIN

EMERGENCY CONTACT

Name

First Name

Last Name

Address

Phone

PERSONAL DETAILS

NZQA Number

Bank Account Number

Tax Code

IRD Number

KiwiSaver

Yes

Kiwisaver Contribution Percentage

Clothing Size

Medical Questionnaire

Name *

Name

First Name

Last Name

Date

YYYY

Do you suffer from Asthma?

If yes, do you carry an inhaler?

Are you allergic to bee stings or sensitive to any subtances / chemicals?

Do you wear glasses / contact lenses?

Are you required to carry any medication with you?

If yes what medication?

Do you suffer from epilepsy, blackouts, or seizures?

Do you have hearing disability?

Do you suffer from diabetes, heart problems or high blood pressure?

Have you ever suffered from a back injury that has required time off work?

Have you claimed ACC in the last 12 months?

State any serious injury or illness you have suffered that may affect your ability to carry out the functions and responsibilities of the position you have applied for?

In your past employment have you been exposed to noise, asbestos, heavy metals, solvents, oils etc?

Have you suffered from occupational overuse syndrome as a result of your last employment?

DISCLAIMER

BY SUBMITTING THIS FORM YOU AGREE THAT ALL INFORMATION PROVIDED IS CORRECT.

Employment Termination

Please complete this form & notifiy your supervisior.

21. (a) This agreement can be terminated by either party giving at least 2 weeks notice of termination or resignation in writing as the case may be (note taken from employment contract).

Date

YYYY

Name *

Name

First Name

Last Name

Last day of work *

The final day of your employment

Reason for leaving company: *

KiwiSaver Opt-Out Form

Employment Contract

(Download, print & return to office)