JOIN OUR CREW

First Name

Legal name

Family Name

Legal name

Preferred Name

Legal name

Where do you live?

Area/City/Country

What's your email

example@example.com

Phone Number

What position would you like to apply for?

Where did you hear about us?

Which store/s are you keen to work in?

Qualifications (name and level if applicable eg Level 4 Certificate in Barbering)

When can you start with us?

DayMonthYear

What type of work would you prefer?

List your last 3 workplaces

Rows	Name of company	Start date	End Date
Employer 1
Employer 2
Employer 3

Drop a short CV and tell us about your work history. If you don't have one now you can send one through later

Are you able to legally work in NZ?

Health and Wellbeing Questions

If you come on board your health and wellbeing is paramount. The Following information is required to assist BarberShopCo meet its obligations under the Health and Safety in Employment the Injury Prevention Rehabilitation and Compensation Act 2001, and to assess your ability to perform the duties of the position.

In relation to the work you will be doing in the store, do you have any difficulties with standing, walking, bending, lifting, or using your hands?

Do you have any physical or medical condition/s that may need to be managed in order to perform your job, including tool handing, cleaning, standing, hand washing, use of products, either on an ongoing basis or from time to time?

Do you suffer from or have you suffered from any injury or medical condition caused by a work related gradual progressive disease or infection (e.g. repetitive strain injury, carpal tunnel, epicondylitis, back injury or strain, hearing loss) which this job may aggravate or contribute to?

Health and wellbeing- please list any notes you'd like us to take into consideration with regards to your health and wellbeing

DECLARATION: I understand that I must disclose any criminal convictions unless covered by the Clean Slate Act 2004 and will look at the Ministry of Justice website for further information should I need to.

DECLARATION: To the best of my ability the information provided in this application and in any resume enclosed is true and correct.

I understand that should my application be successful, this information including my CV, screening and interview will form part of my agreement of employment and that if any false information is given or important information has been suppressed I may not be accepted, or if I am employed, my employment may be terminated.

I also understand that any false information given relating to my medical history may result in my loss of entitlement for any compensation from ACC.

Declaration