Relieving Application - Dunedin Kindergartens

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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 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*

Registration Number

Expiry Date*

Day

Month

Year

Are you a NZ citizen or permanent resident?*

Yes

Do you hold a valid work permit?*

Yes

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

Position

Employer

Start Date

Day

Month

Year

End Date

Day

Month

Year

Reason for leaving

Status

Permanent

Relieving

Add Position Three

Yes

Position

Employer

Start Date

Day

Month

Year

End Date

Day

Month

Year

Reason for leaving

Status

Permanent

Relieving

Add Position Four

Yes

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

Are you awaiting hearing on any charges for any other offences?*

Yes

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

Have you ever been dismissed from a teaching position?*

Yes

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

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

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

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