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Non ECE Trained Relievers
Name *
Address *
Telephone (Daytime)*
Telephone (Evening)
Telephone (Mobile)
Email *
Do you have any pending criminal convictions or court appearances?
Medical Conditions
Is there anything we need to be aware of?
At which Kindergartens would you like to relieve?
What type of relieving are you interested in?
Short Term (day to day)
I am available any week day
I am available only on the following days/times
Please describe any training or experience that is relevant for relieving work in our Kindergartens. If you are currently training as an ECE teacher – please give us details of which course, which provider, and how long you have been studying.
If you are primary trained please give qualification and work history:
Please describe any relevant areas of expertise:
Please provide us with the names of two people who could be contacted for current knowledge of you and your suitability for relieving teaching in our Kindergartens.
Name
Person 1
Telephone
Person 1
Address
Person 1
Name
Person 2
Telephone
Person 2
Address
Person 2
I give permission for Hutt City Kindergartens to make any checks or enquiries that will enable them to establish my suitability to work in kindergartens.
Equal Employment Opportunities (EEO) - Data Sheet
Ethnic origin
Please tick one or more of the boxes below:
New Zealand European/Pakeha
New Zealand Maori
If you wish to identify your iwi
Pacific Islander- please identify which group(s):
Samoan
Tongan
Tokelauan
Cook Island Maori
Niuean
Fijian
Other European (eg British, Australian etc)
Please specify
Other ethnic group (eg Chinese, Indian etc)
Please specify
Gender
Male
Female
Age Bracket
18-25
26-35
36-45
46-55
56-65
66+
Are there any ways in which we can support you in achieving in your job?
For example:
English as a second language?
Supporting you in managing family commitments?
Emotional and Mental Health?
Physical Health and Mobility?
Other areas?
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