Do you suffer from any physical, mental or health condition likely to affect the full performance of your duties? This includes any current/previous ACC Claims within the last 2 years.
Have you ever been diagnosed with/ and treated for occupational over-use syndrome or any other similar condition?
In your past employment have you been exposed to any of the following; noise, solvents, asbestos, skin irritants, heavy metals, infectious metals?
Do you have a predisposition to any other condition that you are aware of, including but not limited to asthma, heart or respiratory problems, high blood pressure or communicable diseases (eg. HIV, Hepatitis).
Note: Detail company name, position held and approx. start and finish dates, or attach CV in next field.
Choose the options which most describe your level of experience for each category.
I consent to Symons Group using TORO (Transport Organisation Register Online) through the New Zealand Transport Agency for the purposes of ensuring that I am fully licensed at all times and/or to monitor my licence status and activity.
View TORO terms and conditions.