Apply for this position here:

Simply complete your personal details below, then answer our questionnaire which is specific to this vacancy.  Your answers to the questionnaire will enable us to process your application faster.  At the bottom of this page please upload your CV and Covering Letter.  We accept files in pdf, .doc or .docx formats, under 4MB.

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You are applying for the position:

Application Form

(All fields are required)

1. Advertising Avenue:
Where did you see this role advertised?

2. Ethnicity :
Please indicate the ethnic group you most identify with from the selection below. This information is gathered for statistical purposes only.

3. Ethnicity - Other:
If you answered "Other" to the above question please write what ethnic group you identify as below. If you have already stated your ethnicity above please write "n/a" to proceed.

4. Education and Qualifications:
Are you a registered Medical Practitioner with the Medical Council of NZ or eligible for registration to enable practice within NZ?

5. Education and Qualifications:
Do you hold a higher qualification appropriate to the practice of General Surgery, which must be recognised by the Medical Council of NZ for vocational or special scope registration as a General Surgeon?

6. Skills & Expertise:
Do you have Upper and lower GI endoscopy skills?

7. Experience:
Do you have at least 2 years Postgraduate general surgery specialty experience as well as demonstrated colonoscopy skills?

8. New Zealand Residency:
Do you have permanent residency in New Zealand?

9. Working authority in New Zealand:
Are you legally authorised to work in New Zealand?

10. Criminal Offences:
Have you ever been charged with or convicted of a criminal offence or released from prison?

11. Criminal Offences:
If "Yes", give brief details (or if "No" to the above question please enter "n/a" to this question):

12. Disclosure Statement:
Do you consent to the disclosure to the Wairarapa District Health Board of whether you have been subject to a serious misconduct investigation, either concluded and upheld or currently under investigation, from all previous Public Service and statutory Crown entity employers for the last three years? This will usually be conducted at the preferred candidate stage.

13. Subject of a Complaint:
Have you been the subject of a complaint to your professional body or the Health and Disability Commissioner? Please state either "No", or if "Yes", please give brief details:

14. Conditions that may affect personal ability:
Do you have any condition that may affect your ability to effectively carry out the functions and responsibilities of the position you are applying for. Please state either "No", or if "Yes", give brief details:

15. Declaration:
I declare that all the information given above is correct, and I give permission for my referees to be contacted. I understand that I may be required to supply originals of any relevant documents supporting this application.

File size limit: 4 MB

(cover letter, selection criteria etc) File size limit: 4 MB

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