Application Form

The completion of this form does not indicate any obligation on the Punchbowl PackCo to engage with you as the applicant. Information is collected for the purpose of assessing your suitability for employment within Punchbowl PackCo, Applicants must be 16 years of age or more. Information that is marked with a ** is collected for Human Resources/Training purposes only and is not used to assess suitability for employment.
My details
How did you first hear about this vacancy?
- Seek
- TradeMe
- Facebook
- Website
- Agency
- Billboards
- Current Employee
- MSD/WINZ
Title*
- Mr
- Mrs
- Miss
- Ms
- Other
Name*
First Last
Preferred Name*
Date of Birth*
Date Format: DD slash MM slash YYYY
Email*
Phone*
Home Address*
Street Address City Country
Ethnicity*
- NZ European
- Maori
- Samoan
- Cook Island Maori
- Tongan
- Niuean
- Chinese
- Indian
I CONSENT to Punchbowl PackCo retaining this information, if you are unsuccessful, for the purposes of considering your suitability for any other position that may arise? If yes, the information will be retained for a period of no more than two months for this purpose only.*
- Yes
- No
Details...*
My abilities
I have been dismissed, or resigned as an alternative to being dismissed?*
- Yes
- No
Details...*
I have been subject to investigation for dishonesty or violence by a previous employer*
- Yes
- No
Details...*
I have a learning (reading or writing) disability ***
- Yes
- No
Details...*
I have a current NZ Driver’s License*
- Yes
- No
Copy of drivers license
I have relevant qualifications, including but not limited to...
- First Aid Cert
- Forklift License
- Horticulture/Agriculture qualifications gained through Primary ITO or Polytech/University
Horticulture/Agriculture qualifications gained through Primary ITO or Polytech/University
Are you legally entitled to work in New Zealand?*
- New Zealand or Australian Citizen
- New Zealand Residence Visa
- New Zealand work/temporary/student visa with conditions
Attach passport and/or visa
Drop files here or
Have you ever worked for Punchbowl PackCo or associated company before?*
- Yes
- No
If yes, where and when:*
Is English your first language?*
- Yes
- No
What is your first language?*
Do you speak any other languages?*
- Yes
- No
If yes what languages:*
Do you have your own transport?*
- Yes
- No
- I rely on transport via a family member or a friend
If you rely on others, do you have an alternative method of transport when they are not available?*
My Availability
Availability*
Season runs approx. mid-March to June. Do you confirm that you are available for this entire period?
- Yes
- No
If no, why not?*
Please indicate days you are available for*
Rolling shifts that run 5 days on one day off
- Select All
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Please indicate shifts you are available for*
- Select All
- Mornings
- Afternoons
- Nights
Do you have another job or personal circumstances that may affect your ability to work when required? If yes, please give details*
- No
- Yes
Details...*
My Experience
Previous Orchard Experience
- Select All
- Picker
- Flower Picking
- Thinner
- Pruner
- Other
Other please specify*
Previous Packhouse Experience
- Select All
- Packer
- Stacker
- Tray Prep
- Grader
- Coolstore
- Other
Other please specify*
My fitness
Fitness to Undertake Work

The purpose of gathering the following information is to enable Punchbowl PackCo to determine whether you have any medical conditions, injury or impairment which may affect your ability to perform the required work. It also will identify areas where there could be a health and safety risk to yourself, or others in relations to such condition, previous injury or impairment has existed.
Note: You will be requested to supply information during interview for any questions that you answer YES too. A prior OOS (RSI) or back condition may not prevent you working for Punchbowl PackCo, although injury documentation may be requested.
Do you have any eyesight difficulties (including but not limited to; colour blindness, blurry vision, etc)?*
- Yes
- No
Details...*
Have you consulted a health professional for back strain?*
- Yes
- No
Details...*
Do you have any other medical condition/injury/impairment (including but not limited to; hearing, asthma, hayfever, etc) that could affect your ability to perform the role that you have applied for, or your employment in general, or might affect you from attending work regularly?*
- Yes
- No
Details...*
Do you need to bring prescription medication to work?*
- Yes
- No
Details...*
Have you been diagnosed with an infectious disease or blood borne infection in the last 12 months? Required due to the role handling food.*
- Yes
- No
Details...*
Past Work Experience
Past work Experience
Please provide past details regarding the business you have worked in and the role that you performed.
NB. Use the + sign to create additional lines.
Company Position including basic tasks
Criminal History
Criminal History

Punchbowl PackCo requires you to disclose all convictions unless that are covered by the Criminal Records (Clean Slate Act) 2004. You must declare all your convictions if you have:
- Been convicted of an offence within the last 7 years; or
- Been sentences to a custodial sentence (e.g. imprisonment; corrective training; borstal); or
- Been ordered by a Court during a criminal case to be detained in a hospital due to your mental condition, instead of being sentenced; or
- Not paid in full, any fine reparation, or costs ordered by the Court in a criminal case; or
- Been indefinitely disqualified from driving under Section 65 Land Transport Act 1998 or earlier equivalent provision.
Do you have any criminal convictions that would not be covered by the above Act?*
- Yes
- No
Details...*
Do you currently have any criminal charges pending?*
- Yes
- No
Details...*
Declaration
Should it be required*
**All fields need to be ticked
- I UNDERSTAND that Punchbowl may require me to attend an unpaid work assessment including a pre-employment drug test. Refusal or a failed test will result in me not being employed. If I am employed before the test results are available and/or I receive a failed test, then my employment will terminate immediately.
- I CONSENT to Punchbowl PackCo undertaking a criminal clearance check through the Ministry of Justice or a third-party provider
I understand and agree to Punchbowl taking a digital photo of me for security and employment purposes.*
- Yes
- No
If no, why?*
I understand and agree to undergoing random drug and alcohol testing should I accept a role with Punchbowl.*
- Yes
- No
If no, why?*
I understand and agree to Punchbowl taking photos and/or videos for the purpose of promotion and marketing.*
- Yes
- No
If no, why?*
I understand and agree that the information supplied in this application is being collected by Punchbowl PackCo. The purpose for which the information is being collected is to determine your suitability for appointment to a particular position at Punchbowl PackCo including those positions for which you have expressed an interest.*
- Yes
- No
If no, why?*
I understand and agree that the information may be supplied to third parties employed or engaged by Punchbowl PackCo and will be retained by Punchbowl PackCo.*
- Yes
- No
If no, why?*
I hereby declare that I have read the above Declaration and I am aware of my rights under the Privacy Act 1993. I certify that the information provided is correct and no information has been omitted.*
- Yes
- No
If no, why?*
Statement of Agreement*
** All fields need to be ticked
- Information provided is correct and complete I certify that the information provided is correct and no relevant material/information has been omitted. I understand that this information will be used for the purposes of processing this application and understand that any incorrect or misleading information or important information that has been omitted during the appointment process may disqualify me from consideration, or if appointed, may result in termination of my employment.
- I consent to Punchbowl providing information to Government Agencies for employment related purposes.
- I declare that I have completed all sections of this application truthfully and shall inform Punchbowl PackCo of any change in my circumstances that affect the answers given above.
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Comments
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Company	Position including basic tasks

Application Form

My details

My abilities

My Availability

My Experience

My fitness

Past Work Experience

Criminal History

Declaration