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Relieving Application
Relieving Application
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2018-08-15T23:59:17+12:00
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Relieving with Dunedin Kindergartens Expression of Interest.
In completing this form, you are providing the background information required to progress to an interview. It is a requirement that applicants hold an NZQA-recognised ECE diploma or degree
Full name
*
First
Last
Previous name/s
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Contact phone
*
Email
*
Ethnicity
*
Teacher Registration Details.
Original documents will be required at interview, and will be certified by our Senior Teacher.
Registration Category
*
Provisional
Subject to confirmation
Full
Registration Number
Expiry Date
*
Day
Month
Year
Are you a NZ citizen or permanent resident?
*
Yes
No
Do you hold a valid work permit?
*
Yes
No
Academic Qualifications:
*
B.Ed Teaching ECE
B.Ed Teaching Primary
NZFKU Diploma
ECE Diploma
Graduate/Post Graduate Diploma ECE
Other e.g Masters
We will need to sight original documents and can be certified by our Senior Teachers.
ECE Qualification Date
*
Day
Month
Year
Employment History.
We will require confirmation from employers of the number of hours you were employed to establish service recognition for salary.
Graduates, please list postings.
Position
Employer
Start Date
Day
Month
Year
End Date
Day
Month
Year
Status
Permanent
Relieving
Reason for leaving
Add Position Two
Yes
No
Position
Employer
Start Date
Day
Month
Year
End Date
Day
Month
Year
Reason for leaving
Status
Permanent
Relieving
Add Position Three
Yes
No
Position
Employer
Start Date
Day
Month
Year
End Date
Day
Month
Year
Reason for leaving
Status
Permanent
Relieving
Add Position Four
Yes
No
Position
Employer
Start Date
Day
Month
Year
End Date
Day
Month
Year
Reason for leaving
Status
Permanent
Relieving
Availability
Indicate days available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Please indicate availability
*
Short-term (less than six weeks)
Long-term (more than six weeks)
Lunch-cover (two hours)
Holiday Programme (two weeks during term breaks)
Are there any periods you are not available?
Health and Safety
Security
Have you ever been convicted of any offence against the law (apart from minor traffic conditions)
*
Yes
No
Are you awaiting hearing on any charges for any other offences?
*
Yes
No
Are their any matters for which you are currently under investigation which may call into question whether you meet the Teaching Council’s ‘good character and fit to be a teacher’ criteria?
*
Yes
No
Have you ever been dismissed from a teaching position?
*
Yes
No
Please provide details for the above.
Health
Do you have any disabilities, injury or medical conditions which may prevent or restrict you from performing any aspect of the job for which you are applying?
*
Yes
No
Please provide details
Do you have any disabilities or medical conditions which may require specific accommodation by the employer or other staff to enable you to perform the job for which you are applying?
*
Yes
No
Please provide details
Do you have any disabilities or medical conditions which may have an impact on the health and safety of yourself, other employees, the children or parents attending the place of work?
*
Yes
No
Please provide details
Referees.
Referees cannot be related to the applicant or to the applicant's extended family.
These two referees should be in the teaching profession and able to comment on your teaching practice. A current or prior manager or supervisor is preferable
I hereby authorise Dunedin Kindergartens to contact the following individuals to act as my referees for the purposes of my application for the above position; as required under section 29 of the Privacy Act 1993.
*
I Agree
Name
Current Position
Relationship
Service
Contact Phone
Email Address
Name
Current Position
Relationship
Service
Contact Phone
Email Address
Personal Information Disclosure Authority
I hereby authorise the collection of personal information from named referees, any current or previous employer, training establishment, other agency or individual, for the purpose of determining my suitability for the kindergarten position for which I am applying, without further reference to me. I authorise DK to disclose such personal information as is necessary for the same purpose.
*
I Agree
Please specify below any agency or individual to whom you do not wish an approach to be made in relation to this application
If you proceed to interview you will need to bring:
Original teacher registration documents
Originals of qualifications, including first aid certificate if you hold one
Proof of identification - two forms of original identification. One must be from category A below, the second from category B
Documents to support periods employed by previous employers
Tax code and IRD number
Bank account details for salary payment
Category A
Current New Zealand Passport
A New Zealand Certificate of Identity issued under the Passports Act 1992 to Non-New Zealand citizens who cannot obtain a passport from their country of origin
New Zealand certificate of Identity (issued to people who have refugee status)
New Zealand Refugee Travel Document
Emergency Travel Document
New Zealand Firearms License
Overseas Passport (with New Zealand Immigration Visa/Permit)
New Zealand Full Birth Certificate issued after 1998
New Zealand Citizenship Certificate
Category B
New Zealand Driver’s Licence
18+ Card (must be current)
Community Services Card
Super Gold Card
Veteran Super Gold Card
Inland Revenue Number
Electoral Roll Records
New Zealand issued utility bill, issued not more than 6 months earlier.
Your authority is required in accordance with the provisions of the Privacy Act 1993. I certify that to the best of my knowledge all information provided in this application is true and correct.
*
I Agree
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