Application for Appointment

Send applications to:

The Principal
Nelson Central School
70 Nile Street
NELSON

Position applied for:

Envelopes should be endorsed
“Confidential Application”
Curriculum Vitae should be
accompanied by a selfaddressed stamped envelope
of sufficient size to enable your
documents to be enclosed.
CV of successful applicant will
be kept on file in the school.

Bi-lingual (Maori) Permanent 1 MU (with extra unit(s)
for additional relevant responsibilities

Personal details:
Name:

____________________________________________

Address: ___________________________________________________________________
___________________________________________________________________
Contact phone number:

Home (

) _______________________

Work (

) ________________________

Present appointment: ________________________________________________________
School: ___________________________________________________________________
Position held:

___________________________________________________________

Names, addresses and phone numbers of three referees, at least one of whom should be
your current or past senior manager or principal and can comment knowledgeably on your
performance as a teacher. In lieu of this reference, Beginning Teachers should supply copies
of reports from Associate Teachers on teaching practices.
Name:

___________________________________________________________________

Address: ___________________________________________________________________
Phone No: Home: (

) _________________ Work: ( ) _______________________

Capacity you have known the person:____________________________________________
Name:

___________________________________________________________________

Address: ___________________________________________________________________
Phone No: Home: (

) _________________ Work: ( ) _______________________

Capacity in which you have known the person:_____________________________________
Name:

___________________________________________________________________

Address: ___________________________________________________________________
Phone No: Home: (

) _________________ Work: ( ) _______________________

Capacity you have known the person:____________________________________________

Education Qualifications:

Date Awarded

_________________________________________

______________

_________________________________________

______________

_________________________________________

______________

_________________________________________

______________

Registration Details:
Full

(Please circle)

Provisional

Expiry date __________

Registration number: ___________________________

Teaching Service
School

Class

Scale

From

Until

_________________________________

____

_____

_____

____

_________________________________

____

_____

_____

____

_________________________________

____

_____

_____

____

_________________________________

____

_____

_____

____

_________________________________
____
(Please continue on a separate sheet if necessary.)

_____

_____

____

Declaration:
Have you ever been convicted of an offence against the law apart from summary offences?
No

Yes

(If yes, please provide date and details on a separate sheet)

I give permission for any records the police may hold on me to be given to the Board of Trustees as
part of the application process.
I certify I am registered as a New Zealand Teacher and have a current practising certificate.
Do you have an existing condition that would prejudice the execution of your duties? (If yes, please
provide date and details on a separate sheet)
I declare that to the best of my knowledge the information given in this application and my C.V. is true
and correct.

Applicant’s signature: ___________________________________________

(For office use only) Date application received: _________________________
Please complete for statistical purposes:
Ethnicity: __________________________ Gender: ________

Date: _____________

Age: <30

31-40

41-50

51-60

61+ (please circle appropriate)

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