Register with Bupa

Completing this form does not impose or imply any obligation on Bupa Care Services to employ you.
This form collects personal information about you for the purpose of assessing your suitability for employment at Bupa Care Services and, if employed, for the purposes of managing the employment relationship. Failure to provide all of the information requested may impair our ability to assess your suitability and compromise our ability to choose the right person for the position. Under the Privacy Act 1993 you are entitled to access and request the correction of any personal information held by Bupa Care Services.

Personal Details

Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Age

Hours Available to Work

Legal Work Status

Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html
Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Languages

Employment Background

General

You are not required to disclose convictions which meet the requirements of the Criminal Records (Clean Slate) Act 2004
To qualify for not disclosing your criminal convictions, you must have:

  • No convictions in the last seven years; and
  • Never been sentenced to prison, home detention, corrective training or borstal; and
  • No convictions of a “specified offence” (this includes sexual offending against children or young people – for a full list see www.justice.govt.nz/publications/global-publications/c/criminal-records-clean-slate-act-2004); and
  • Never been ordered by the Court to go to hospital or a secure facility (instead of a sentence) due to your mental condition; and
  • Paid all your fines, reparation and Court costs; and
  • Never been indefinitely disqualified from driving for driving offences involving alcohol or drugs.

Medical

Are you vaccinated against...

Other Document

Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Reference Consent

Declaration