Driver Application


Part 1: Driver Screening

This information is collected for the purpose of assessing your suitability for employment at ABGL. Only those involved in the application process will have access to the information contained in this form. Should you be successful the information contained in this file will be used to update your personal records. Information relating to unsuccessful applicants will be destroyed.


Personal Contact Details
Name *
Name
1. Residency
Resident Work Status *
Are you fluent in the English language? *
Are you applying for Class 4 or Class 5?
(tick which applies)
2. Availability
Work Availability *
Are you able to work
3. Licence Status
Licence Type *
Do you consent to Alexander Bulk Gases Ltd conducting a Toro (NZTA) licence check?
Dangerous Goods Endorsement: *
4. Driving Experience
New Zealand Roads
How many year's experience do you have?
How long have you been driving the Class 4 or 5 licence that you hold?
Driver Experience
5. Employment History
6. Drugs and alcohol
Do you consent to a drug and alcohol test if you proceed to the next stage of application? *
7. Driving Infringements
Do you currently have any demerit points? *
Have you had any driving infringements in the last 5 years? *
8. Criminal Offences
Have you been convicted of a criminal offence in the last 10 years? *
Are you awaiting the hearing of any charges (criminal or civil)? *
9. Medical
Do you have any history or medical condition e.g. hearing loss, asthma, blackouts, sleep apnoea or narcolepsy, repetitive strain injuries or stress-related issues which may be aggravated or contributed to by the work associated with this role? *
Are you at present receiving medical treatment or on medication? *
Have you had any ACC claims in the last 5 years? *
Comments and CV Attachment
Write or paste your CV here. Field will expand to fit text.