Welcome to Customwood by Daiken
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Thank you for your interest in working for Daiken New Zealand Ltd

We pride ourselves on our high professional standards and thorough and fair recruitment process.

We would appreciate you spending the time to complete this form fully. The completion of this form does not indicate any obligation by Daiken NZ to engage you in employment.

If you proceed past an interview we may require reference, medical, drug and security checks (and in some cases financial).

Please ensure you have completed all the required information and signed the declaration at the bottom of the application form.



A. Introduction:

The information you provide in this application form will be used to help us assess your suitability for the position. You need to ensure that the information you provide is entirely accurate. The provision of false information may be grounds for dismissal if your application is successful.

All information you give us will be treated confidentially and kept secure. The information will only be released in accordance with the authorisations you provide to us in this form.

If your application is successful, this form will become part of Daiken NZ Limited personnel records. You are entitled to access the information upon request. If your application is unsuccessful, this information will be securely stored in our archives for a temporary period and then destroyed.



B. Personal Details:




C. General:



D. Qualifications and Skills

Accepted File Types : .pdf, .doc[x], .txt, .jpg

Please do not complete this section if your application is accompanied by a CV that contains the information requested in this section.



E. Licences

5 files maximum. Accepted File Types : .pdf, .doc[x], .txt, .jpg



F. Criminal Convictions*

* Please be aware that you are not obliged to declare certain offences which occurred more than 7 years ago under the Criminal Records Clean Slate Act 2004. If you have any doubts please seek legal advice before completing these questions and the Ministry of Justice Criminal Convictions Report request form at the back of this Daiken NZ application form.



G. Employment History

Please do not complete this section if your application is accompanied by a CV that lists your previous employment. Please list all of your previous roles below (start with your last or present position and work backwards) and explain any gaps:



H. Referees

Please list 3 referees that Daiken NZ can contact to discuss you and your ability to perform the role:

Referee 1


Referee 2


Referee 3




I. Health & Safety

The Health & Safety in Employment Act requires Daiken NZ to identify hazards and to provide a safe place of work. A person’s physical state may pose a hazard for themselves and other staff, hence the reason for these questions:



Daiken NZ Limited
Drug & Alcohol Free Workplace Policy

Daiken NZ is committed to creating a drug and alcohol free workplace to ensure the safety, health and wellbeing of its people. Daiken NZ will support its employees in achieving this goal through the following initiatives:

Pre-employment Testing
Preferred candidates will undertake a pre-employment drug test in order to ensure that all practicable steps are taken to minimise potential or actual risk of harm to its employees, customers, contractors or visitors to the Company. The offer of employment will be forwarded to the candidate after due consideration of the drug test results.

Post-accident or Post-incident Testing
Employees may be requested to participate in a test for the presence of drugs and/or alcohol where they are involved in an accident, incident or ‘near miss’ which impacts (or potentially impacts) on the safety, health or well being of employees, contractors or visitors.

Reasonable Cause Testing
Employees may be requested to participate in a medical test where their actions, appearance, behaviour or conduct suggests that they may be under the influence of drugs and/or alcohol.

Random Drug Testing
Due to the safety-sensitive nature of the work we undertake, we may test you for drugs or alcohol at random intervals.

The Company offers its employees the opportunity to seek appropriate drug and/or alcohol rehabilitation.

Serious Misconduct
Employees observed taking, selling, transferring or being in the possession of drugs and/or consuming alcohol at work will be subject to disciplinary action which may result in termination of employment.



Privacy Declaration

Privacy statement and consent

Daiken NZ is committed to protecting the privacy of all the individuals it deals with. It is bound by the National Privacy Principles, as set out in the Privacy Act 1988, and other applicable privacy legislation. Where appropriate, Daiken NZ will handle your personal information relying on the related bodies corporate and employee exemptions in the Privacy Act and other applicable exemptions in other legislation.

In the course of conducting a pre-employment drug test Daiken NZ may collect personal information (including sensitive and health information such as the drug test results) from you or third parties.

We collect this information to ensure that all practicable steps are taken to minimise potential or actual risk or harm to Daiken’s employees, customers, contractors or visitors and to assess your suitability for the position with Daiken for which you have applied. If we do not collect the personal information it will limit our ability to perform these tasks.

Generally, we will (unless otherwise required or authorised by law) only disclose your personal information to third parties for the purposes mentioned above or for related purposes. This may include disclosure to related companies of Daiken or insurers and statutory bodies (such as workers' compensation bodies).

You have certain rights to access personal information that Daiken hold about you under the Privacy Act and other applicable legislation. You can find out more about how to do this by contacting your HR Manager. In some cases we may impose a moderate charge for providing access.

Privacy Statement Consent

I agree that my personal information (including sensitive and health information) can be collected, used, transferred and disclosed by Daiken NZ as contemplated by this Privacy Statement and Consent.

Declaration Pre-Employment Drug Testing

Consent to pre-employment drug test

I have had the opportunity to read Daiken NZ’s Drug & Alcohol Free Workplace Policy and consent to undergoing a pre employment drug test for the purposes described in the Policy.


I certify that the information I have given on this application form is true and correct. I understand that if I have given incorrect or misleading information, or if I have left out any important information, I may not be considered for appointment, or if appointed, my employment may be terminated.