Application form
Please complete your name below and each of Sections A to D of this form.
Refer to the ‘Guide for Applicants’ for further information on this form and the
recruitment process.
Name:
Position applied for:
Deputy State Services Commissioner
Department:
State Services Commission
Section A - Competency self assessment
The Deputy State Services Commissioner, State Services Commission (SSC) needs to be skilled in the
competencies identified in the position description. These competencies have been described below. This
competency self assessment will be used to assist in the process of evaluating applicants.
Please provide two to three examples (for each competency area described below) of projects, tasks or
occasions where you have demonstrated the competency.
These competency descriptors are based on the Leadership Success Profile. The full leadership success profile
is available from the SSC website, please visit www.ssc.govt.nz/leadership-success-profile for more information.
Competency Descriptors
Deliver Results Through Execution
The Deputy State Services Commissioner will need to manage performance and efficiency and utilise high quality, timely and
well understood performance information to track and manage performance and risk. They must also be able to sustain
ongoing continuous improvement and reform of the current system.
Deliver Results With People
The Deputy State Services Commissioner will need to ensure the SSC workforce has the capacity and diversity to deliver on
its vision and strategy, and must also proactively recognise and seek through the Senior Management Team to remedy any
diversity and capability gaps or shortfalls.
Deliver Results Through Vision
The Deputy State Services Commissioner needs to set coherent and achievable strategies, aligned with system and sector
priorities, with challenging objectives and success measures. They must also develop and generate common ownership of
outcomes with Ministers, sector and agency leaders and central agency partners.
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Deliver Results Through Self
The Deputy State Services Commissioner must be able to navigate complex political situations effectively and take the lead
on controversial issues while adapting and thriving in challenging environments. She/he must maintain and model Public
Service standards of integrity and trust and inspire respect, trust, loyalty and confidence of staff and stakeholders. The
Deputy State Services Commissioner will need to actively encourage, listen and action feedback and remain calm and
objective in the face of conflict and criticism.
Citizenship and Security Clearance
1.
The appointee must be a New Zealand citizen. Are you a New Zealand Citizen?
Yes / No (please delete one)
2.
The appointee will be subject to a New Zealand Government Top Secret Special security clearance. Please detail any
areas of concern that may prevent you from gaining a Top Secret Special security clearance.
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Section B - Referee details
We are looking to create a 360 degree picture of your personal attributes, behaviours, and skills, in relation to
those detailed in the position description. To this end, please provide us with the details of referees at various
levels who can make informed comment on your skills based on observations. These will be current and
previous managers, peers, junior staff members, direct reports, or others.
Please ensure you provide each referee’s name, title, relationship to you, and contact phone numbers.
It is anticipated that these referees will not be contacted unless you are the preferred candidate for the
position. However, we will advise you if we choose to seek referee comment earlier in the recruitment
process.
Referee details
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Section C - Authorisation in terms of the Privacy Act 1993
Authority to approach other referees
I authorise the State Services Commissioner, or his nominated representative, to approach persons other than
the referees whose names I have supplied to gather information related to my suitability for appointment to the
position of Deputy State Services Commissioner, State Services Commission.
Signature:
…………………………………………………..
Name in Print: …………………………………………………..
Date:
…………………………………………………..
Authority to verify qualifications and undertake credit checking
I authorise the State Services Commissioner, or his nominated representative, to verify the qualifications listed in
my curriculum vitae. I also authorise the State Services Commissioner, or his nominated representative, to
undertake credit checking.
Signature:
…………………………………………………..
Name in Print: …………………………………………………..
Date:
…………………………………………………..
Authority for security checking and vetting of personal suitability
I give my authority to be security checked and vetted by the New Zealand Police, the Serious Fraud Office and
the New Zealand Security Intelligence Service in the event that I am considered suitable for appointment to the
position of Deputy State Services Commissioner, State Services Commission.
Signature:
…………………………………………………..
Name in Print: …………………………………………………..
Date:
…………………………………………………..
Citizenship held (please list):
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Section D - Criminal Conviction Declaration
Have you ever been convicted of any offence against the law, in New Zealand or
any other country?
Yes
No
Yes
No
(Please note: This question is subject to the provisions of the Criminal Records (Clean
Slate) Act 2004. This Act gives eligible individuals the right in some circumstances to
withhold information about their convictions. See ‘Guide for Applicants’ for further
information about this point.)
Do you have any criminal charges pending, in New Zealand or any other country?
If the answer to either question is YES please provide full details, including the date and nature of the charges
(and the expected hearing date if applicable):
(Note a false declaration about prior convictions and/or pending prosecutions will invalidate your application.)
Signature: ……………………………………………….. Date:
………………………………………..
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