Driver Employment Application

Applicant Details

Proposed Driver’s Name:

Address:

Mobile Number:

Email:

Home Phone:

Drivers Licence #:

Version Number:

Expiry Date:

Drivers DOB:

Attach Copy Of Licence:

Classes / Endorsement Held (Please Tick):
123456DFPRTW

Do you give permission for your driver licence to be registered on the NZTA TORO driver check system? YesNo

Do you have any conditions attached to your licence (e.g. Medical)? YesNo

If yes, please give details:

Next Of Kin Details

Contact Name:

Relationship:

Emergency Phone Numbers:

Address:

Details

Do you have a current Dept. of Labour (OSH) fork lift operator’s certificate? YesNo
If yes, what is the expiry date?

Employment History (Note: must be the three most recent):

• • Most Recent Employer
• • Contact Name & Phone Number
• • Employed From / To
• • Reason For Leaving

Do you give permission for NZL Group Ltd to contact any of your past employers listed above for verification of your work history? YesNo

Are you familiar with products NZL Group Ltd cart on a daily basis? YesNo

Detail your transport experience:

Have you ever been convicted of a criminal offence? YesNo

Are you awaiting a Court appearance on any transport related offences? YesNo

Have you had any time of work in the past 5 years with back related problems? YesNo

Have you been on ACC in the past 5 years for anything other than back or spinal related issues? YesNo

Please give details if you answered Yes to any of the above questions:

If your application for employment is successful when would you be available to start work?

As part of NZL Group Ltd’s Health and Safety Policy, we require all staff to participate in our Drug and Alcohol testing procedure. This involves pre-employment, post incident, reasonable cause, and random testing.

Before you can be considered for employment, you will be required to undergo pre-employment drug and alcohol testing. All costs associated with this test shall be met by NZL Group Ltd. If employed this would be mandatory.

Do you accept these terms? YesNo

Do you consent to a check for criminal convictions being undertaken? YesNo

Signature: (type your name)

Date: