Application for Employment
Instructions for Applicant
Complete this Application for Employment and give to the People Leader at the interview.
Please bring with you the original valid documents, as set out below to identify you and show evidence of your entitlement to work in New Zealand.
If you are a NZ Citizen bring either A, B or C:
If you are a Non NZ Citizen bring either A, B, C or D:
A New Zealand passport
A Passport with a valid New Zealand work visa and the visa conditions that allow
you to work for BNZ
B New Zealand birth certificate AND photo identification*
B Passport with a New Zealand Residence class visa
C New Zealand citizenship certificate AND photo identification*
C Australian passport
D Passport with an Australian permanent residence visa or a current returning
resident’s visa
*(Photo Identification can be a NZ or international Driver Licence, 18+ Card or NZ Firearms Licence)
Please complete all details including the Ministry of Justice Request forms.
(For the Ministry of Justice Request only: If you are unable to provide photo ID, please complete the proof of identity on page 6).
Please ensure you sign the declaration on page 3 and the Ministry of Justice Request form on page 5.
To be completed by Applicant
1.Personal Information (please print)
Mrs
Mr
Ms
Other
Miss
Surname Given name/s Preferred name Email Current address
Street address Time lived there
Suburb Town/City Y
Postcode Y
M
M
Telephone numbers
Day 0 Evening 0 Mobile 0 2. Entitlement to work for BNZ
Are you legally entitled to take up employment in New Zealand?
Yes
No
If yes, which of the following applies
NZ citizen
Australian citizen
Residence permit/residence visa
Copy attached
Work permit/work visa (please state expiry date)
Student visa
D
D
M
M
Y
Y
D
D
M
M
Y
Y
Copy attached
Copy attached
3.Previous employment history
Have you ever been dismissed from a role in which you have been employed?
Yes
No
If yes, please give details
1
4.Conflict of interest
Are you involved in any business interest, other employment or role that may present a conflict of interest in the role you have applied for?
Yes
No
If yes, please explain
5.Financial statement
In the last five years have you been, or are you currently:
>> an adjudicated bankrupt?
Yes
No
>> admitted to the No Asset Procedure?
Yes
No
>> the subject of a Summary Instalment order?
Yes
No
>> a director of a company placed in liquidation or receivership?
Yes
No
>> a debtor in respect of a court judgment for a debt or debts?
Yes
No
>> prohibited by a court or the law from taking part in the management of a company or business?
Yes
No
If you answered yes to any of these questions, please give details
6. Employment checks
BNZ has a special relationship of trust and confidence with its customers and within the community. This places an obligation on Bank employees to act
with trust and integrity at all times. For this reason pre-employment checks will be undertaken through external agencies before an offer of employment
can be made.
Previous address in the last 3 years
Street address Time lived there
Suburb Town/City Postcode Y
Y
M
M
Previous address in the last 3 years
Street address Time lived there
Suburb Town/City Postcode Y
Y
M
M
List all the countries you have lived in for 12 months or more in the last 5 years, with the dates you began and ended living there.
If you do not know the exact dates please provide approximate dates.
Country
Arrival Date
Departure Date
7.Criminal convictions
Have you ever been convicted of a criminal offence or are you awaiting a criminal court hearing
that is not protected by the Criminal Records (Clean Slate) Act 2004?
If yes, please give details
Yes
No
To ensure you are correctly identified, please advise
Have you ever changed your name by Deed Poll?
Yes
No
If yes, previous name
Are you known by any other name?
Yes
No
If yes, other name
Date of birth
D
D
M
M
Y
Y
2
8.Employment references
Please provide contact details for two work-related referees – your two most recent reporting managers. We will not contact your referees without your consent.
Referee name Referee name Referee’s Company
and Position Title Referee’s Company
and Position Title Referee contact details
Phone Referee contact details
0 0 Phone Email Email Your working relationship with referee e.g. Direct Manager
Your working relationship with referee e.g. Direct Manager
9.KiwiSaver
Are you an existing member of KiwiSaver?
Yes
No
If yes, please indicate what percentage you are contributing
3%
4%
8%
10.Privacy Act
The information provided by you in this Application for Employment will be held by BNZ and will be used to assess your suitability for employment. This
may include disclosure to third parties for the purposes of credit, court, qualification and membership checks where appropriate. It may also be used for
statistical purposes.
If your application for employment is successful, the relevant information provided by you in this Application for Employment will be entered into the
Bank’s central HR Database. This database is secure and all information is treated as strictly confidential. The information will be used by BNZ and NAB
Group to manage the employment relationship between you and BNZ.
Your name, location and BNZ contact details (including your email address) may also be disclosed to organisations which have been engaged by BNZ
e.g. Officers’ Provident Association (superannuation) for the purpose of introducing you to the benefits and services offered to staff members. These
organisations may contact you by way of email, without an unsubscribe facility.
In respect of opening accounts, loan applications and reviews, you authorise the BNZ Group to make credit references and other enquiries within its
normal procedures. For this purpose, the BNZ Group may seek from any such source information concerning you. In the event that you are in default
under any loan or facility from the BNZ Group, the BNZ Group is authorised to disclose all relevant personal information to and for the use of credit
reference agencies, debt collection agencies and law firms.
You have a right to access this information and to seek any correction you think necessary to ensure accuracy.
11.Declaration and authorisation for use and disclosure
I declare that the information I have provided in this Application for Employment and any accompanying documents provided by me is true and complete.
I consent to this information being collected, retained, stored and used in the manner described above.
I consent to BNZ undertaking employment checks on me. I understand and acknowledge that this may include credit checks, national and international
criminal checks, immigration checks, Anti-Money Laundering and Counter Financing of Terrorism Act 2009 and any other employment checks required
by law and/or by BNZ or NAB Group policy.
I understand that if the Bank’s employment checks uncover any adverse information, or if false information is given or material suppressed by me,
I may not be accepted for employment or, if I am employed, that my employment may be terminated.
Applicant’s Signature D
D
M
M
Y
Y
To be completed by People Leader
Instructions for People Leader
Complete the People Leader section below.
Sight original identification and evidence of the candidate’s entitlement to work in New Zealand (as per the requirements under “Instructions to applicant” at
the beginning of this form).
Verify the applicant against the photo identification provided and check that the signature on the identification matches the signature on this application form.
All original documents must be sighted and verified before they can be processed.
Photocopy these documents and validate with your signature and date.
Ensure that the Application for Employment form is completed and signed by the applicant.
Scan this form with verified copies of documents to your Talent Acquisition Consultant to commence probity and offer processes.
(3052) 100542 06-13
Send original form to People Advisory Centre 0100A01, Auckland
People Leaders name
Location Code
Position applied for
Name of Talent Acquisition Consultant
3
4
Ministry of Justice Request
The Ministry of Justice will only accept original versions of this form.
You can request a copy of your Personal Information held by the Ministry of Justice form
Privacy Unit
Ministry of Justice
National Office
PO Box 2750
WELLINGTON 6140
Part 1 – Applicant’s authority to release information to a third party
I hereby authorise the Privacy Unit, Ministry of Justice, to release a copy of my personal information about me on the computer systems administered by
the Ministry of Justice relating to all criminal history to the following third party:
Pre-Employment Checks
People Advisory Centre
BNZ
PO Box 995
AUCKLAND 1140
Note: The signature you scribe below, must match the signature on the ID that you have submitted with this form.
Applicant’s Signature D
D
M
M
Y
Y
People Advisory Centre
representative’s Signature D
D
M
M
Y
Y
I wish to receive a copy of the information provided to the third party
Yes
No
Part 2 – Applicant’s details (this should match what is written on the ID that you have submitted with this form)
Given name/s Surname Date of birth
D
D
Place of birth
M
M
Y
Previous names, maiden name, aliases, or deed poll changes
Y
Current residential address
Street address Time lived there
Suburb Town/City Postcode Y
Y
M
M
Telephone numbers
Home 0 Mobile 0 Previous address in the last 3 years
Street address Time lived there
Suburb Town/City Do you hold a valid NZ Driver Licence?
Postcode Yes
Y
Y
M
M
No If yes, valid Driver Licence number
Registration plate number/s of all vehicles currently owned by Applicant
5
Part 3 – Proof of identity
Only to be completed if you do not have a valid NZ Driver Licence or passport – ask someone who can confirm your identity to fill out this section.
The person who identifies you must
Have known you for more than 12 months
Be aged 18 and over
Not be a relative
Not live at the same address as you
Have a daytime telephone number
Be contactable during normal business hours
Given name/s Surname Current residential address
Street address Suburb Town/City Postcode Telephone numbers
Day 0 Evening 0 Mobile 0 I declare that I have personally known
Applicant’s Given Name/s for
Identifier’s Signature Applicant’s Surname years and vouch for his/her identity.
D
D
M
M
Y
Y
The Ministry of Justice will only accept original versions of this form.
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