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Application Form

Come work with us!

Select an option
Drivers Licence
Do you have access to a reliable vehicle?
Current First Aid Certificate?
Do you know NZ Sign Language?
Weekend work may be required from time to time, would this be a problem for you?
Are you legally entitled to work in New Zealand?
Are you prepared to handle all products, materials or equipment used in the industry?
Work Entitlement
Have you ever been charged with, or convicted of, a criminal offence (including pending prosecutions)?
Nursing Level (if applicable)
Training and Experience - select all that apply


Please check all days that apply & indicate hours available for each day (e.g. 9am - 5pm or 9am - 12pm & 3pm - 6pm)


Employment & Referee Information

Have you previously worked for Home Comfort Ltd?

Most Recent or Current Employer

May we contact them?

Previous Employer

May we contact them?

We require two (2) work related referees to contact. If you have not supplied us with two above, please provide us with the additional referees below.

Reference 1

Reference 2

Health & Physical Particulars

Have you ever suffered a back injury requiring time off work?
Have you ever claimed Accident Compensation (ACC)?
Are you at present receiving medical treatment and/or medication?
Do you have any condition(s) (e.g. asthma, allergies, hearing loss, sensitivity to chemicals, mental health or stress related conditions) that may be aggravated by or affect your ability to effectively carry out the functions and responsibilities of the position you're applying for?


Please attach the following documents that apply to your application:

Upload File - PDF/DOC(X)
Upload File - PDF/DOC(X)
Upload File - jpg

Disclosure of Convictions

Thank you! We'll be in touch if your application is successful.

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