Please read this information before completing this form.
We are committed to protecting your privacy and maintaining confidentiality, and also to using the information you have provided to help match you to suitable job opportunities.
Important information about your personal details:
Sometimes we need to talk to people such as previous employers, job referees, referring agencies and training organisations to help us build a picture of your skills and abilities. We will always get your permission before contacting anyone for this purpose.
We may also need to talk to potential employers when looking for suitable work for you. Again, we will get your permission first.
The work we do to try to find you suitable employment is generally paid for by another organisation such as the Ministry of Social Development (MSD), ACC or an insurance company. They require us to provide them with information about the services we have provided to you and to notify them if you are employed through our employment service.
They may contact you to confirm you have received services from us.
We sometimes use independent companies to undertake customer surveys on our behalf.
You may be contacted by one of these companies and invited to take part in a survey about the quality of our services. Of course you don’t have to participate, and you can opt out of future contact
Your personal information is stored by Workbridge at our National Office and at the Workbridge centre where you enrolled. We have comprehensive security arrangements in place that protect against loss or misuse of your personal information.
You can access the information we hold about you at any time, you just need to ask.
You can ask us to change any information we hold about you that is not correct.
You are currently living in New Zealand.
You are a New Zealand citizen or permanent resident.
You are aged between 16 to 64 years old inclusive.
You have a disability or health condition that is likely to impact on your ability to work for six (6) months or more.
Exceptions to Eligibility
You qualify for vocational rehabilitation from the Accident Compensation Corporation (ACC)
You are being provided vocational services by the Ministry of Health.
You are enrolled at a secondary school
If you don't meet these conditions, need help with the form, or are unsure if you might qualify, please contact our friendly team on:
Phone: 0508 858 858 (between 8:30am and 6:30pm, Monday to Friday)
Relationship with Work and Income
Please select one of the following statements that apply to you
You are receiving a benefit, or your partner is receiving a benefit.
You have applied for and been assessed as eligible for a benefit.
You were receiving a benefit that has been cancelled because you started work.
You have applied for a benefit but need to complete pre-benefit activities.
You have contacted Work and Income or Workbridge for assistance to obtain or remain in employment in addition to support provided by Work and Income.
You are not receiving a Supported Living Payment (sickness, injury or disability) because you are on a work trial with the agreement of Work and Income for a period of time.
You will be applying for a Supported Living Payment (sickness, injury, or disability, or total blindness).
You are receiving New Zealand Superannuation or a Veteran's Pension as a non-qualified spouse or partner.
I have no relationship with Work and Income
Suburb or Town
Preferred Contact Method
Permanent Resident of NZ
How did you find out about us?
Family or Friend
MSD/Work and Income
Other Workbridge Jobseeker
Social media (other than Facebook)
Walking past a Workbridge office
Website other than Workbridge
Other (specify other)
Brain Injury Society
Mental Health Agency
Pacifica and Migrant Group
Police and Corrections (EG Probation)
Supported Employment Agency
Bay of Plenty
Nelson, Marlborough and West Coast
Taranaki, King Country and Whanganui
Great Barrier Island
Queen Street Auckland
Five Cross Roads
Glenview Shopping Centre
Nearest Workbridge branch to you?