IMPORTANT NOTES FOR APPLICANTS FOR TEACHING POSITIONS
Submitting an Application
This form is to be used to apply for all teaching positions at Waitara High School. Make sure
you sign and date where indicated.
A separate form must be used for each position applied for.
Attach a CV containing additional information. If you include written references, please note that
we may contact the writers of the references.
Copies only of qualification certificates should be attached.
If you are selected for an interview you may bring whanau/support people at your own expense.
Please advise if this is your intention.
Failure to complete this application and answer all questions truthfully may result in any offer of
employment being withdrawn or appointment being terminated if any information is later found
to be false.
Criminal Convictions
In terms of a criminal conviction, the Criminal Records (Clean Slate) Act 2004 provides that
certain convictions do not have to be disclosed providing:
 You have not committed any offence within 7 (consecutive) years of being
sentenced for the offence and
 You did not serve a custodial sentence at any time (this would exclude serious
offences such as murder, manslaughter, rape and causing serious bodily harm) and
 The offence was not a specified offence (specified offences are in the main sexual
in nature) and
 You have paid any fine or costs
Custodial sentences include a sentence of preventive detention and corrective training. Noncustodial sentences include fines, reparation orders, community-based sentences and
suspended sentences. Please note that you are not obliged to disclose convictions if you are an
eligible individual but can do so if you wish. If you are uncertain as to whether you are eligible
contact the Ministry of Justice.
Removal Expenses
It is important to note that before accepting an appointment to a position which would
necessitate moving, that the applicant must find out whether they are eligible for removal
expenses.
Closing Date for Applications
It is the applicant’s responsibility to ensure that the application reaches Waitara High School
before the closing date. Where there is any doubt, applicants should telephone the Principal
before the closing date and advise that a formal application has been sent.
The successful applicant’s application form and supporting documents will be held by the
school. You may access it in accordance with the provisions of the Privacy Act 1993.
If you have any queries, please contact the Principal.
OFFICE USE ONLY: This page must be retained on file as part of the application; it
must not be removed or destroyed.
WAITARA HIGH SCHOOL
Application for Appointment to a Teaching Position
Position Applied for
Personal Details
Surname
First Name(s)
Postal Address
Telephone No. ( )
Cell
Email
Postcode
Previous Surname (if used in teaching)
Gender (for statistical purposes only)
Male / Female
Date of Birth (optional)
________ / ________ / ________
Day
Month
Year
Category of Teacher Registration (with the New Zealand Teacher Registration Board)
Registration Number:
Expiry Date:
Full Registration
Registered Subject to Confirmation
Provisional Registration
Not Registered
Other (please specify)
Qualifications
Certificates, Degrees,
Diplomas, or other relevant
qualifications
Subjects or papers passed
and levels
Date and year completed
Post or email your application to:
Enquiries:
Mrs Jenny Gellen, Principal
Waitara High School
P O Box 188
Waitara 4346
Phone: (06) 754 7514
Fax:
(06) 754 7199
Email: admin.office@waitarahs.school.nz
Present Employment
Teaching Position Held
(specify)
Permanent
Date Appointed
Part Time
Relieving
Other (specify)
If not teaching state present occupation ____________________________________________
Teaching Service (details in date order – use separate sheet if necessary)
Position
Employer
Start
Date
Other Relevant Experience (use a separate sheet if necessary)
Particular Strengths/Interests (use a separate sheet if necessary)
Finish
Date
Referees
Approval is hereby given for the Waitara High School Board of Trustees to contact the referees
below and enquire about the professional performance of the applicant.
Please list the names, designations and contact details of three referees.
Name
Designation
Address
Phone
Bus ( )
Home ( )
Bus ( )
Home ( )
Bus ( )
Home ( )
Declaration (If you answer YES to any question, please provide details on a separate sheet)
1
Have you ever been convicted of a criminal offence?
Yes
No
2
Have you ever been dismissed from a teaching position?
Yes
No
3
Have you ever been refused registration or classification?
Yes
No
4
Have you ever had registration or classification as a teacher
cancelled in any country?
Are you aware of any medical condition which the Waitara High
School Board of Trustees should take into consideration in deciding
whether to appoint you to the position?
Are there any reasons why you should not be employed in a school
environment?
It is law that New Zealand school sites are all non-smoking zones.
Would you have any difficulty complying with such a policy?
Yes
No
Yes
No
Yes
No
Yes
No
5
6
7
I,______________________________________________, do solemnly and sincerely declare
that to the best of my knowledge and belief, the information given in this application is true and
correct.
Signature
______________________________________
Date
_________________________