(All fields are required)
1. Advertising Avenue:
How did you hear about this opportunity?
2. Residency Status :
Which option best describes your current residency status?
How many years Nursing experience do you have?
4. Nursing Registration:
Do you have registration from the New Zealand Nursing Council and a current Annual Practising Certificate?
5. Technical Skills:
Do you have experience with InterRAI?
6. Suitability :
In 100 words or less why do you believe you are the most suitable candidate:
Have you been referred by a current Selwyn employee?
8. Relatives/Friends :
Have you any relatives or friends currently employed by the Foundation Group? If so please state your relationship to this person. If this is not applicable please write N/a
9. Prior Selwyn Employment :
Have you ever been employed for the Selwyn Foundation or any of its subsidiaries before?
10. Hearings :
Are you awaiting the hearing of charges in a civil or criminal court of law?
11. Criminal Offences :
Have you ever been convicted of a criminal offence, including driving convictions? (excluding any convictions under the Clean Slate Act 2002)
12. Dismissal :
Have you ever been dismissed from a position for disciplinary reasons?
13. Medical Information 1 :
Do you know of any reason or suffer from any disability which might affect your ability to perform the duties associated with the job applied for?
14. Medical Information 2 :
Have you had any injury or medical condition caused by gradual process, disease or infection, e.g. hearing loss, repetitive strain injuries, sensitivity to chemicals, that may be aggravated or further contributed to by the tasks of this job?
15. Declaration 1 :
I declare that to the best of my knowledge the information provided in this application and in any CV is accurate and I understand that if any false or misleading information is given, I will not be employed, or if employed, may be terminated.
16. Declaration 2 :
I consent to the information provided in this application being retained for considering my suitability for other positions which may arise, & consent to the information gained being provided to any member of the Selwyn Foundation Group.
Please check that you have provided us accurate information