Sales

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Application Form V9 22/5/13

18/3/14

P. O. Box 4059,
Hamilton East 3247

Phone: (07) 859 2805
Email: info@digipoll.co.nz

APPLICATION FOR EMPLOYMENT
CONFIDENTIAL

Date of Application_____________

NAME:
Last

First

Middle

Number

Street/Road/Cres/Ave

City/Town

ADDRESS:

TELEPHONE NO:

MOBILE NO:

EMAIL:

POSITION:

TELEPHONE INTERVIEWER

SHIFT TIMES:
The following shifts may be available:
§

MONDAY – FRIDAY: 9-11am, 11-2pm, 2-5pm, 5-8.30pm, 5.30-8.30pm.

§

SATURDAY & SUNDAY: 10-12pm, 12-3pm, 3-5pm.

How many shifts/ hours can you work each week?

I am aware that the nature of work at DigiPoll is casual and is contingent upon the demand for
DigiPolls’ services. DigiPoll reserves the right to roster staff at its’ own discretion.
CURRICULUM VITAE
A copy of your CV with educational and work history is required. Please include 2 referees we may contact.
Have you attached your C.V.?
Yes

No

Yes

No

Have you included names of 2 referees?

Page 2 of 2

Application Form V9 22/5/13

18/3/14

Do you have a family member/s who currently works at DigiPoll? I.e. Parent, sibling or close relative.
Name of Relative:__________________________________Relationship:_______________________________
Name of Relative:__________________________________Relationship:_______________________________

LEGAL
Are you legally entitled to work in New Zealand?
(If holding a current work visa a copy must be provided)

Yes

No

Do you have any present criminal convictions?
(Not including any concealed under the Clean Slate Act)

Yes

No

MEDICAL
Do you have any health related issues, that may impact on your ability to perform the tasks required, including any psychological disorder that you are currently receiving treatment for?
Yes
No
If ‘ YES’ please provide details below:
If…...

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