Employment Application Form

The information you provide on this Employment Application form will be collected and held by HFH Limited and will be used for recruitment purposes only.
This application is in no manner or form, a guarantee of employment.
The information collected here is to assess your suitability for employment. Employment, if offered, is at the discretion of the company.
If your application is successful, this information shall form part of your personnel file.
If your application is unsuccessful, it will be held for three (3) months and will then be destroyed.

NB: This is a physically demanding and overtime industry. Successful applicants must be prepared to work extended hours during the summer construction period.

Concrete Truck Driver

full time

Masterton

Personal Information

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Phone Numbers

Driving History

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Driver Licence Details:

Please attach a photocopy of your driver's licence

Maximum upload size: 64MB per file.

Higgins Concrete Limited uses the NZ Transport Agency’s Driver Check system to verify licence details. In signing this form you permit NZTA to release the information to Higgins.

Class 1 Car Licence 400kg or less

LearnerRestrictedFull

Class 2 Medium Rigid Vehicles 15001kg or less

LearnerFull

Class 3 Medium Combinations 25001kg or less

LearnerFull

Class 4 Heavy Rigid Vehicles 15000kg or more

LearnerFull

Class 5 Heavy Combinations 15000kg or more

LearnerFull

D Dangerous Goods Endorsement
F Forklift Endorsement
R Roller Endorsement
T Tracks Endorsement
W Wheels Endorsement

Please indicate the years and level of experience you have, in operating the following vehicles and/or machines.

In the past five (5) years, has your driver's licence at any time been cancelled or suspended? If yes, please detail.

YesNo

Have you incurred any speeding fines or other traffic infringements in the past three (3) years? If yes, please detail.

YesNo

Have you ever been involved in any vehicle crashes in the past three (3) years? If yes, please detail.

YesNo

Have you ever been disqualified from driving due to alcohol or drug-related offences? If yes, please detail.

YesNo

Education

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Please name Secondary School(s), University, Polytechnic or other Institutions Attended.

Please name any Qualifications gained (eg: School Certificate, University Enterance, NCEA).

Please name any other Qualifications gained (eg: Polytechnic, University, Apprenticeship).

Please describe the skills/training you hold which are relevant to the position applied for.

Employment History

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Have you ever been employed by a Higgins Concrete or in this industry?

YesNo

Please detail your Employment history (starting with your current or most recent employment).

Health

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Have you ever suffered from vision impairment? (eg: use of contact lenses, glasses for driving)

YesNo

Have you ever suffered from back/shoulder pain and/or injury?

YesNo

Have you ever suffered from any overuse injuries?

YesNo

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

YesNo

Do you suffer from epilepsy/seizures?

YesNo

Have you ever suffered from hearing/ear problems?

YesNo

Migraines/Headaches
Raised Blood Pressure
Bone Disease/injury
Stress related illness
Diabetes/Thyroid disease
Skin Problems / Dermatitis
Asthma/Bronchitis/Tuberculosis/Lung Disease
Muscular Pain/Tendon Injury

Details

Do you have, or have you ever had any medical conditions, injury or injuries, which may affect you in the performance of any of the essential tasks and responsibilities of the position you are applying for

Please give details of all previous work and non-work accidents and state whether Accident Compensation was paid.

Applicants will, during the pre-employment process, be required to have a health assessment to consider their suitability to carry out the tasks required of them for the type(s) of employment they are interested in. HFHL is committed to providing a drug free workplace, and as such, applicants will be required to pass a drug and alcohol test prior to employment.

General

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Are you legally entitled to work in New Zealand?

YesNo

Please select the option that applies to you.

New Zealand CitizenNew Zealand ResidentWork Visa/Permit

Evidence of eligibility for employment in New Zealand may be required prior to any employment offer.

Are you prepared to work overtime?

YesNo

Have you ever brought a personal grievance against a prior Employer?

YesNo

Are you awaiting the hreaing of charges in any Civil or Criminal Court of Law? If yes, futher infromation relevant to potential employment may be sought at any subsequent interview.

YesNo

Have you ever been charge with or convicted of a criminal offence either in New Zealand or overseas that is not concealed under the Clean Slate Legislation?

YesNo

Referees

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Please give details of any work related referees that you authorise us to contact.

Declaration

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Please read carefully and sign

I authorise Higgins HFH Limited to obtain information from the above nominated referees concerning my suitability for employment and release such person from liability from any claims which may arise from the provision of such information.

I further declare that the information I have provided in this Application Form, (including what is in my CurriculumVitae where provided), is correct. I understand that should I be successful in my application, falsification or deliberately misleading information or suppression of information will be grounds for instant dismissal.

Sign above using your mouse or touch screen.

Additional Information

Please attach any additional information, which would assist your application. Please provide only copies of documents as it is not our policy to return CV’s. Please be aware that we may need to sight original documents prior to employment being offered.

Maximum upload size: 64MB per file.