APPLICATION FOR SEASONAL EMPLOYMENT

The information collected is for assessing suitability for employment with Cedenco Foods New
Zealand Ltd.
If successful, this information will be kept on your personal file. If your application is not
PURPOSE successful, the information you have provided will be disposed of securely at the end of the
processing season (generally September of each year).
This form must be completed in full and signed by the applicant to be considered for
employment.

PERSONAL INFORMATION

First Name: ................................................... Surname: ........................................................

NAME
Preferred Name: ............................................ Gender: ..........................................................
(Statistical purposes only)

Contact Address:...........................................................................................................................
......................................................................................................................................................
CONTACT ....................................................................... Post code: .......................................................
DETAILS Phone:........................................................... Alternative Ph:................................................
Email Address: ..............................................................................................................................
Note: We require a contact phone number or alternative means of contact, and a valid email address

EMERGENCY First Name: ................................................... Surname: ........................................................

CONTACT
DETAILS Phone: ........................................................... Relationship: ..................................................

Have you reached the current school leaving age of 16? Yes / No
AGE
ID MUST BE PROVIDED – SEE BELOW SECTION

Eligibility to Work in New Zealand

New Zealand Citizen – NZ Birth Certificate* / NZ Passport Yes / No

Permanent Resident – Residency Certificate & Passport Yes / No
If you are NOT a NZ citizen – Valid Work Visa for NZ & Passport Yes / No
LEGAL WORK
*If you supply a Birth Certificate, you must supply a valid form of Photo ID
STATUS
New Zealand citizens
 New Zealand Passport (Includes people born in the Cook Islands, Niue, and Tokelau)
 New Zealand Birth Certificate or New Zealand Citizenship Certificate
 AND acceptable Photo ID (NZ Drivers Licence, Firearms Licence, 18+ card)
Non-New Zealand citizens
 Australian Passport
 Foreign passport with valid NZ work permit; (e.g. Resident Visa, Working Holiday Visa)
 EMPLOYMENT HISTORY

Have you previously been employed by Cedenco Foods NZ Ltd, T&G or ENZAFOODS NZ LTD?
Yes / No
If Yes, which department and when: ……………………………………………………………………………………..

The last two Employers you have worked for:

Name of Company: ......................................................................................................................
Approximate start and finish dates: .............................................................................................

EMPLOYMENT No. of hours worked per week: ....................................................................................................

HISTORY Position Held / Duties: .................................................................................................................
Reason for Leaving: ......................................................................................................................

Name of Company: ......................................................................................................................

Approximate start and finish dates: .............................................................................................
No. of hours worked per week: ....................................................................................................
Position Held / Duties: .................................................................................................................
Reason for Leaving: ......................................................................................................................

Have you ever worked in a factory environment before? Yes / No

Previous experience: ....................................................................................................................

EXPERIENCE ......................................................................................................................................................
Do you have secondary / other employment? Yes / No
Details: .........................................................................................................................................

Name: ........................................................... Company: .......................................................

Position: ......................................................... Phone: ............................................................

Relationship to you: .....................................................................................................................

REFEREES
Name: ........................................................... Company: .......................................................
Position: ......................................................... Phone: ............................................................

Relationship to you: .....................................................................................................................

For the Privacy Act 1993, I consent for the company seeking verbal or written information from my
nominated referees or previous employers listed above to ascertain my suitability for the position
I am applying for with Cedenco Foods New Zealand Ltd. I understand that the information
CONSENT received by the company is supplied in confidence as evaluative material and will not be disclosed
to me.

Sign:............................................................... Date:..............................................................
 MEDICAL INFORMATION

I agree to undergo a pre-employment medical and drug test as part

of the Cedenco recruitment process Yes / No
I agree to any biological, progressive disease/injury monitoring if
applicable to the job (ref Health and Safety at Work Act 2015) Yes / No
Are you fully vaccinated against COVID-19? (Not a requirement) Yes / No
Have you suffered vomiting or diarrhoea in the last 2 weeks? Yes / No
Have you made an ACC claim in the last 5 years? Yes / No
GENERAL Have you ever had a work-related injury? Yes / No
MEDICAL
Are you currently receiving rehabilitation for an injury? Yes / No
QUESTIONS
Are you involved in any sport or recreational activity that may impact
on your ability to do this job? Yes / No
Do you have any condition which may affect your ability to effectively carry
out the functions / responsibilities (see below) of the position applied for? Yes / No
 Responsibilities of positions in the Factories include: Grading, packing,
lifting up to 20kg regularly, handling of food products, cleaning the factory,
the wearing of Personal Protective Equipment. All positions require standing
for prolonged periods and a good level of fitness is required.

 Responsibilities of positions in Yard include: Working outdoors (all weather

conditions), working inside chillers.

If YES provide details: ……………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………

We need to be sure that we do not place anyone at risk when we assign staff to various roles.
Please indicate if you suffer from any of the following medical conditions or physical
conditions that may affect your ability to safely perform the task you are applying for:

Hearing Loss  Eye Conditions 

Chemical Sensitivity  Heart Conditions 
Repetitive Strain Injury  Asthma 
HEALTH Shoulder /Neck / Back Pain  Epilepsy 
INFORMATION Abnormal Blood Pressure  Muscle Pain / Discomfort 
Arthritis  Surgical Procedures 
Diabetes  Motion Sickness 
Any other medical concerns:........................................................................................................
......................................................................................................................................................
…………………………………………………………………………………………………………………………………………………
NB: Answers that indicate an existing injury or condition will be considered on an individual basis
and will not automatically prevent you from being employed.
 CEDENCO REQUIREMENTS

I am wanting to apply for the (please circle) Hasting Site Gisborne Site

Location Hours I am available to work are…………………………………………………………………………………………….

&
NB: Hours of work are subject to change with the needs of production or specific requirements
Availability within a role.
Are you prepared to work Weekends and Stat holidays Yes / No
Have you worked shift work before? Yes / No
Are there reasons we should be aware of that would prevent you working
certain days / hours?....................................................................................................................

EDUCATION / QUALIFICATIONS
Some (but not all) roles require a good competency of verbal communication skills in English,
VERBAL and/or good reading /writing /numeracy skills. Please circle your level of ability:
READING Verbal English: Poor / Average / Excellent
WRITING Written English: Poor / Average / Excellent
NUMERACY
SKILLS Reading English: Poor / Average / Excellent
Numeracy: Poor / Average / Excellent

High School / Tertiary Qualifications Attained:.............................................................................

EDUCATION Do you have any other qualifications / certificates that may be relevant? Yes / No
…………………………………………………………………………………………………………………………………………………

Do you have any criminal convictions, not including those concealed

CRIMINAL under the Criminal Records (Clean Slate) Act 2004 or any pending charges? Yes / No
HISTORY
If YES, please provide details ......................................................................................................

Cedenco Foods New Zealand Limited has a Drug and Alcohol Policy that
involves pre-employment, random, reasonable cause, and post incident testing.

In the event of an accident/incident/near miss/reasonable cause or given rise to the suspicion

DRUG TESTING
of usage of drugs/alcohol or you are randomly selected during your employment or for
Pre-employment purposes, do you agree to undergo a drug test or alcohol test? Yes / No

Sign: …………………………………………………………………….. Date: …………………………………………………

DECLARATION I understand that completion of this form does not indicate there is any obligation on
Cedenco Foods New Zealand Limited to offer me employment.

I declare that to the best of my knowledge the information provided by me in this application
form and on any CV attached is true, accurate and complete and is not designed to mislead in
any way. I understand that if any false or deliberately misleading information is given, or any
material fact suppressed, I may not be accepted for employment, or if I am employed, my
employment may be terminated.
 As part of this application, I understand and agree that a CV accuracy and Ministry of Justice
Criminal record Check may be completed.

I further understand that any offer of employment made is conditional on my obtaining

medical clearance through the company pre-employment process.

....................................................................... .......................................................................
(Signature) Date)

 Social Media
 Billboards
HOW DID YOU
 Word of mouth
HEAR ABOUT
US?  Current or previous employee………………………………………………………(Name)
 Employment search online
 Other…………………………………………………………………..

 All areas of this Application form are complete.

CHECK LIST  All contact details are correct.
PLEASE  Application is signed and dated where required.
 Appropriate ID supplied.
ENSURE:
 Copy of your CV supplied.
 For Forklift positions, a copy of your current OSH certificate is supplied