Veterinarian professional background form page - Vet Jobs with VetStaff

Name*

Prefix First Last

Your PREFERRED name

if your preferred name is different to your first name

Date of birth*

Address type*

Will your address be a PO Box or physical street address?

PO Box
Physical Street Address

Address*

Street Address Address Line 2 City Region / State / Province Post Code Country

PO Box Address*

Email*

What type of work are you looking for?*

Full Time Permanent
Part Time Permanent
Locum

Phone*

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Bank Account Number*

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Your IRD Number

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Your GST Number - if registered

Do you carry your own professional indemnity & public liability insurance?*

Yes
No

Have you ever had an insurance claim? If "yes" please elaborate*

No

Your LinkedIn Profile URL

Your Facebook Profile URL

Your Twitter Profile URL

Your personal website URL - if you have one

Qualifications + University*

Year of Graduation*

Please enter N/A if you don't hold a university qualification

Are you currently NZVC registered?*

Yes
No

Your right to work in New Zealand*

NZ Citizen
NZ Permanent Resident
Working Holiday Visa
Essential Skills Work Visa
Work to Residence Visa
Still to be decided

When does your visa expire?*

To verify your visa status what is your Passport Number AND Country of Issue?*

Current supervisory conditions*

No

Drivers Licence*

Yes
No

Own reliable transport*

Yes
No

Emergency Contact Person

Name*

First Last

Relationship to you*

Email

Phone*

Step 1 of 4 - CONTACT INFO & QUALIFICATIONS

Emergency Contact Person

Work Experience - last 5 years

PRACTICE PREFERENCE

REFEREES

Far North / Bay of Islands / Northland
Auckland
Hamilton - Waikato
The Coromandel
Bay of Plenty
Rotorua
Gisborne / Eastland
Hawke's Bay
Ruapehu
Lake Taupo
Taranaki
Whanganui
Manawatu
Wairarapa
Horowhenua
Kapiti Coast
Wellington
Nelson - Tasman
Marlborough
West Coast
Christchurch / Canterbury
Wanaka
Queenstown
Waitaki
Fiordland
Central Otago
Dunedin
Invercargilll
Southland
Clutha
Anywhere in the North Island
Anywhere in the South Island
Somewhere "urban"
Somewhere "country" / "rural"
Any "large-ish" city
Any "small-ish" city / town

Hourly Rate	Daily Rate