Medifab Career Application Form

We're excited that you are interested in joining our team at Medifab. To be considered for one of our vacancies, please complete this application form and we'll be in touch with you either via email or phone as soon as we can.

Salutation*

Mr, Mrs, Ms or Miss

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Given or First Name*

Middle Name or Initials

Surname*

Home Add 1 (Street)*

Home Add 2 (Suburb)*

Home Add 4 (Post Code)*

Home City*

Home Country*

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Email Address*

Cell Phone Number*

(Or home number) Please enter with a dash between numbers - e.g. 02X-XXX-XXX Enter with international country code if applying from outside NZ

Position Applied For*

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Experience & Qualifications Summary*

Please give a short outline of key relevant previous experience here. Please use the file upload for full CV's and Resumes

Your goals in working for Medifab?*

Hourly Rate & Other Reimbursements (Desired)*

Work Visa or Citizen?*

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Work Visa Type (Describe)

Work Visa Expiry Date

Referee(s) & Contact Phone Number(s)

Please note at least one referee and their contact details

Do you have a criminal record?

Notice your right to answer as you see fit in the event that you have a conviction which falls under the Criminal Records (Clean Slate) Act 2004.

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Please attach your MoJ form at the file attachment option at the end of this application form if you have an existing one.

I consent to Medifab seeking a criminal convictions check where applicable.

Do you have any medical conditions or disabilities that would make it difficult for you to perform the tasks in the job description, be aggravated by the type of work you would be undertaking or which could compromise your health and safety or that of others in the workplace?

Please make sure to read the position description and select an appropriate answer from the drop down list below, so we can consider how we may assist you.

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Do you smoke?

Yes

Have you received a COVID-19 Vaccine?

Yes

Prefer not to answer

If no, and the role required you to be vaccinated would you be agreeable to receiving the vaccine?

Yes

Are you allergic to, or have any sensitivity to any substances or chemicals?

Consents & Declarations

I consent to pre-employment health and drug screening if this is relevant to the position in question.

I declare that to the best of my knowledge the information I have provided in the application form and in any attached resume is accurate.*

I understand that if I gave any false or misleading information, or suppressed any material fact, I will not be employed or, if I was employed, my employment will be terminated without notice.*

I discovered this job oppourtunity from:*

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File Attachments

Please attach your CV and any other supporting documents (e.g. references etc.). Please note that we can only accept applications with a CV attached.

Drag and drop files here or

Send me a copy of my responses

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