POSITION APPLYING FOR: Click here General Manager Assistant Manager Administrator Club Manager Supervisor Activities Co-ordinator Pride Escape Co-ordinator Pride Escape Supervisior Volunteer

First Name                           Middle Initial                        Surname

Gender:

Date of Birth:

Current Address:

Street and Apt. #.                     Suburb                         City                        Post Code

Permanent Address (if different from above):

Street and Apt. #.                     Suburb                         City                        Post Code

Telephone:                        Mobile:

Email:               Drivers License #

I am a New Zealand Citizen or otherwise authorized to work in New Zealand on an unrestricted basis:

Yes
No

If applicable, please list your visa type, visa # and expiration:

Have you ever been convicted of a felony?*
Yes
No

If you answered yes, please explain:

EMPLOYMENT HISTORY

Present or Most Recent Employer

Employer:   Address:

May we contact:
Yes
No

Telephone:   Mobile:

Your Position:   Salary:

Duties:

Dates of Employment: to

Reasons for Leaving:

Prior Employer

Employer:   Address:

May we contact:
Yes
No

Telephone: Mobile:

Your Position: Salary:

Duties:

Dates of Employment: to

Reasons for Leaving:

Prior Employer

Employer:   Address:

May we contact:
Yes
No

Telephone:   Mobile:

Your Position:   Salary:

Duties:

Dates of Employment:   to

Reasons for Leaving:

Five year work history

EDUCATIONAL HISTORY

High School

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Special Honors or Awards:

Technical or Vocational School

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Degree or Certification:   Specialty:

Special Honors or Awards:

College or University

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Degree:   Major:

Special Honors or Awards:

POSITION INFORMATION

Position Specifications

Position Applying For:

How did you hear about this job?

For how long do you intend on working for Pride Lands?

Are you willing to travel for the job?
Yes
No

When would you be able to start?

Desired Salary:

Skills

Full Drivers license?
Yes
No

Current first aid certificate?
Yes
No

Please describe any skills you have in the following areas:

Child Care:

Communication:

English Language:

Language spoken (other than English):

Computer:

Other:

REFEREES (Please nominate at least two referees for us to contact)*

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate my prior educational and employment history.

Full Name: Date:

I have e-mailed /or mailed (please tick) my:

POSITION APPLYING FOR: Click here General Manager Assistant Manager Administrator Club Manager Supervisor Activities Co-ordinator Pride Escape Co-ordinator Pride Escape Supervisior Volunteer

First Name                           Middle Initial                        Surname

Gender:

Date of Birth:

Current Address:

Street and Apt. #.                     Suburb                         City                        Post Code

Permanent Address (if different from above):

Street and Apt. #.                     Suburb                         City                        Post Code

Telephone:                        Mobile:

Email:               Drivers License #

I am a New Zealand Citizen or otherwise authorized to work in New Zealand on an unrestricted basis:

Yes
No

If applicable, please list your visa type, visa # and expiration:

Have you ever been convicted of a felony?*
Yes
No

If you answered yes, please explain:

EMPLOYMENT HISTORY

Present or Most Recent Employer

Employer:   Address:

May we contact:
Yes
No

Telephone:   Mobile:

Your Position:   Salary:

Duties:

Dates of Employment: to

Reasons for Leaving:

Prior Employer

Employer:   Address:

May we contact:
Yes
No

Telephone: Mobile:

Your Position: Salary:

Duties:

Dates of Employment: to

Reasons for Leaving:

Prior Employer

Employer:   Address:

May we contact:
Yes
No

Telephone:   Mobile:

Your Position:   Salary:

Duties:

Dates of Employment:   to

Reasons for Leaving:

Five year work history

EDUCATIONAL HISTORY

High School

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Special Honors or Awards:

Technical or Vocational School

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Degree or Certification:   Specialty:

Special Honors or Awards:

College or University

Name and Address

Did you graduate?
Yes
No

Attended from:   to

Degree:   Major:

Special Honors or Awards:

POSITION INFORMATION

Position Specifications

Position Applying For:

How did you hear about this job?

For how long do you intend on working for Pride Lands?

Are you willing to travel for the job?
Yes
No

When would you be able to start?

Desired Salary:

Skills

Full Drivers license?
Yes
No

Current first aid certificate?
Yes
No

Please describe any skills you have in the following areas:

Child Care:

Communication:

English Language:

Language spoken (other than English):

Computer:

Other:

REFEREES (Please nominate at least two referees for us to contact)*

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

• Name:   Phone:

Email:   Fax:

I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate my prior educational and employment history.

Full Name: Date:

I have e-mailed /or mailed (please tick) my: