Registered Health Professional

Are you a New Zealand Citizen or Permanent Resident?

Yes, NZ Citizen

Yes, Permanent Resident

No, neither

Do you hold a current Full New Zealand driver’s license?

Yes

Please upload a copy of the front of your driver’s license.

Please upload a copy of the back of your driver’s license.

Have you had any criminal convictions (in NZ, Australia or anywhere else overseas) including any road traffic convictions?

Due to the nature of our business and our contract requirements, all potential and current employees are required to provide information on past and current convictions to ensure client and employee safety is maintained and reviewed at all times. In accordance with the Children’s Act 2014 and the NZ Police recommendations the employee will consent to Ember to submit a Police vetting request at the commencement of employment and every three years thereafter. Should an employee misrepresent their criminal history or driving license at any stage of the employment process (i.e. Ember Application form, interview, induction, or thereafter), and/or in the event an adverse Criminal vetting record is received, Ember may, after consultation with the employee and careful consideration of the facts, terminate the employment agreement without notice. Any record of criminal convictions will not be released if the applicant meets the eligibility criteria stipulated in Section 7 of the Criminal Records (Clean Slate) Act 2004, unless: a. Section 19(3) of the Clean Slate Act applies to this request (exceptions to the clean slate regime) b. Section 31(13) of the Children’s Act 2014 applies to this request (safety checks of core children’s workers).

Yes

If you have selected yes to having had any criminal convictions, please specify - type of conviction(s) and when it took place.

This will allow us the chance to review against our contracts and if we can proceed. This also allows the opportunity to ask further question or not be surprised if appears in checks.

Are there any actions pending (in NZ, Australia or anywhere else overseas) which could result in criminal conviction?

Yes

Please provide details about these pending actions which could result in criminal conviction.

If, registered within New Zealand, What registration do you hold?

This role requires candidates to hold a current annual practicing certificate. Please provide evidence of registration

Are there any pending investigations/or actions against your registration?

Yes

Do you have any injuries, medical conditions, or other personal circumstances that may be aggravated by or impact your ability to do the following tasks?

Qualification and Registration

You will need to be Registered with Nursing Council of New Zealand, please upload a evidence of your registration/annual practicing certificate.

If you have answered "Yes" to any of the above questions, please specify in details:

Are you currently taking any medication that may impair your judgement or impact on your ability to effectively carry out the duties of the position applied for?

Yes

If you have answered "yes" to the above question, please specify.

What pronouns do you use?

At Ember, we are deeply committed to fostering inclusivity and diversity. We strive to create an environment where everyone, regardless of their background or identity is valued, respected and supported. As part of this culture, please indicate the pronouns you use by circling one of the following: They/Them or She/Her or He/Him or Ze/Zir or Other.

Personal information

First name

Last name

Phone

Address

Upload CV

Additional files

Cover letter

Provide clinical support and mentor staff while delivering frontline mental health care, assessments, and recovery-focused support across the North Shore.

Personal information