Have you worked for Sport Waikato*

Do you know anyone who works or has worked for Sport Waikato*
Do you have secondary employment?

Have you ever been convicted of a criminal offence?*

Are you awaiting the hearing of charges in a civil or criminal court of law?*

Please note that you are only required to disclose information as per the Criminal Records (Clean Slate) Act. Please note that any offers of appointment will remain conditional upon a satisfactory outcome of police vetting (or ‘criminal record check’ for non-VCA roles) and the decision as to whether an individual is suitable or not for a given position remains with Sport Waikato.
Do you have a current drivers licence?*

Are you able to operate a manual vehicle*

Languages spoken

Should your application be successful, Sport Waikato will take all reasonable steps to ensure that you are not appointed to a position which will endanger your health or safety, and that significant hazards associated with the position you are applying for are identified and managed.

Employment at Sport Waikato can involve a variety of potential hazards. Sport Waikato takes its responsibilities seriously and will do all that it can to identify, assess and manage these hazards to minimise the chances that harm or illness may occur.  Pre-existing medical conditions and human factors issues are relevant and will influence how we manage your safety and wellbeing. 

Given the above context we need the following information as part of our assessment of your ability to safety carry out the employment tasks of the position you are applying for.

Do you have any known condition or live with the effects of any gradual process injury, repetitive strain injury, a long-standing illness, medical condition or injury that may:
be aggravated by the position you are applying for?*

affect your ability to effectively and safely carry out the functions and responsibilities of the position applied for?*

put other employees at risk?*

Do you regularly take any medication or have you had treatment, where side effects could affect your ability to do the position you applied for safely?*

Over the past three years, have you required days of work or modifications to your work, due to work or non-work related stressors?*

In the last five years, have you made any work related claims to ACC?*

Do you agree to undergo a medical examination if required, at the expense of Sport Waikato and that the results can be made available to Sport Waikato*

Do you consent to the Company retaining the information contained in this application form for the purposes of considering your suitability for this or any other position, which may arise with this Company in the future?*