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Employment Application Form
In order to be considered for employment with Complex Chronic Illness, please complete and submit this application form. All information you provide is strictly confidential.
Please attach a cover letter, a curriculum vitae (CV) and copies of relevant qualifications.
Position applying for:
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Fundraising Officer
Grants Writer
Both Fundraising Officer and Grants Writer
Name
*
First name
Last name
Address
*
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Email address
*
Phone
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Other phone
Ability to work
Are you a permanent resident of New Zealand?
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Yes
No
If NO, do you have a valid work permit?
Yes
No
N/A
Have you ever been convicted of any criminal offence?
*
Note: CCI Support policy requires all staff to undertake a criminal check prior to employment.
Yes
No
Do you have any criminal charges pending?
*
Yes
No
Have you been the subject of a professional disciplinary enquiry?
*
Yes
No
Do you want to give further information about the above questions?
Do you have a full, current drivers license?
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Yes
No
Have you had any injury or medical condition caused by gradual process, disease, infection or other means – which the tasks of this job may aggravate?
*
Note: CCI Support has a smoke free policy. Please be aware we do not discriminate on health reasons - we ask, so that we can look into how we can adapt the role to be more accommodating for you.
Yes
No
If Yes, please give further details
Why are you interested in joining our team?
*
Qualifications & Professional Memberships
Please list any applicable to this role
Ability to start
If successful with this position, when is the earliest you'd be able to start?
*
Declaration:
I declare that to the best of my knowledge the information provided in this application and in any resume enclosed is accurate and I understand that if any false or misleading information is given, or any material fact suppressed, I will not be employed, or if I am employed, my employment may be terminated.
I agree
*
By submitting this form I am officially applying for this role and may be contacted by CCIS in relation to this application.
Cover Letter
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Curriculum Vitae
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Qualifications
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Supporting Documentation
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Please check the highlighted fields
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