Waimea Nurseries


Employment Application Form

Please note: Fields marked with an asterisk (*) are required.

Personal Details


Availability for Work

Are you currently located in the Nelson/Tasman region?*
Are you willing and able to work at least 40 hours per week?*
Do you have any commitments that may prevent you from attending work?* (e.g. sports, PD, meetings)
Do you have a current driver's license?*
Please select applicable car license
Do you have your own reliable transport?*


On a commercial tree nursery all employees will be engaged in physical activity, often outside in the open and working with/near plants, soil/potting mix and may involve using agricultural chemicals.

Have you had an ACC claim for a physical injury or medical condition in the last 5 years?*
Do you suffer from a sore back?*
Do you use any medication (prescribed or otherwise) that may influence your ability to concentrate, operate machinery/vehicles or otherwise impact on your ability to come to work or properly perform your job?*
Do you suffer from any severe allergies or reactions?* (e.g. hay fever or insect bites)
Do you have/know of a reaction to horticultural sprays?*
Do you have any current medical condition or other limitation that we should know about before you started work?*
Have you previously or do you currently suffer any wrist problems (such as RSI, Gradual Process Disease, etc)?*
Vision: Can you comfortably see work that is arm's length away?*
Hearing: Do you have any hearing problems or loss?*
Are you prepared and able to perform physical work that is repetitive in nature and often involves bending over and squatting?*

Employment - General

Employment History

(1) Last or Current Employer

(2) Employer before the one above

(3) Employer before the one above


Do you have previous experience in the following? Please provide details and bring copies of training records if asked to attend an interview.

Do you have an 'F' endorsement?*
Do you have an OSH certificate?

Entitlement to work in New Zealand

ALL applicants must be NZ citizens OR have NZ residency OR hold a valid NZ work visa and ALL applicants will be required to provide evidence they can work in New Zealand if employed (i.e. passport)

Are you a NZ citizen or resident?*

Further information

Have you ever been convicted of a criminal offence or are you awaiting a criminal court hearing?*


I declare that I agree: to providing a record of my ACC Claim History to Waimea Nurseries if requested; to providing Waimea Nurseries with a Police Check should they ask me for one; to undertaking a pre-employment drug test if required by Waimea Nurseries and agree to undertake additional and/or other testing if required as per Waimea Nurseries Alcohol and Drugs Policy should I be offered employment; and to Waimea Nurseries contacting my previous employers for the purpose of a reference check.

I certify that the particulars given by me, in this application form or otherwise, in support of my application are in all material respects true and correct and may be relied upon. I understand that if any false information is given, or any material fact suppressed, I may not be accepted, or if employment has commenced, may result in termination of employment. I also understand that any false information given in relation to my medical history with regard to gradual process, back injuries, or hearing loss may result in my loss of entitlement for any compensation.