Application For Employment
Thank you for your interest in this role. We have a strong commitment to promoting equality and diversity in our recruitment and selection process and we wish to assist and support disabled job applicants through the recruitment process.
In accordance with the Data Protection Act 1998, the Company wishes to inform you that the information you provide will be processed for personnel and statistical analysis. Please sign here to indicate your consent to this process:
Name: Signature:
Position you are applying for:
How did you hear about this role?
Salary Expectation:
Personal Information
All questions should be answered completely and accurately – this section will not be included in the interview selection procedure
Mr/Mrs/Ms/Miss Surname: First Names:Address:
Are you permitted to work in the UK in accordance with the Immigration and Asylum Act 1999?
Yes/No
If you are not an EU citizen, you must provide documentary evidence of your right to work in the UK.
Email Address:
Mobile No: / Landline:
Gender: M / F / Religion:
Nationality: / Ethnic Group:
DoB: / Age:
First Initial and Surname:
Do you have any registered disabilities? YES / NO
Please give details:
If “Yes”, please state what type of adjustments to working arrangements would over come any disadvantage that your disability might otherwise cause you at work or during your interview:
Providing information on your disability will in no way have a detrimental impact on your application or the selection process.
Do you hold a valid driving licence?* YES / NO
Please give details of any endorsements on your licence
* It is only necessary to answer this question where the job you are applying for will involve driving on company business. If this is the case, we will require a photocopy of your driving licence when you commence.
Do you have any unspent criminal convictions? YES / NO
If yes, please give details:
Educational Record
Educational establishments attended(Names and addresses) / Dates / Degrees, Diplomas, Certificates obtained.
Give subjects taken, results and
Grade Obtained
From / To
Schools
Further Education and other Formal Training
College / University
Employment History – Last 5 jobs – Starting with most recent
Company Name& Address
& Salary / Dates / Main Duties &
Reasons for Leaving
From / To
1/Present
2
3
4
5
Why are you considering a change of employer/job role? Why are you applying for this role?
Apply the requirements of the Job/Person Specification here
The following sections are for you to write any information you think will support your application. We are looking for evidence that you have the skills, abilities, knowledge and experience needed to perform the job you are applying for.
The information you provide should relate to the information outlined in the Job Description and clearly address the criteria set out. Please continue on separate sheets of paper if necessary.
Experience
Skills/Abilities
Key Achievements
Other Attributes – What will you bring to this role?
EXTERNAL CANDIDATES ONLY: How much notice do you need to give your present employer?
External Candidates:
Please give name and addresses of two professional referees (only to be taken up if we are considering offering you the role).
Name:-Position:-
Company:-
Address:-
Postcode:
Telephone Number:-
Email Address: / Name:-
Position:-
Company:-
Address:-
Postcode:
Telephone Number:-
Email Address:
Declaration
I confirm that to the best of my knowledge and belief, all the information given in this form is true and complete and that I have not withheld any material fact. I understand that any appointment will be made on the basis that the information given on this form is true and correct.
I understand that if I have failed to disclose information, or have given incorrect information this may result in an offer of appointment being withdrawn, or in disciplinary action or dismissal at a later date.
Offers of employment made to external candidates will be subject to satisfactory completion of background checks as well as taking up references and we will require you to sign a separate consent form to allow such checks to take place should we make you an offer.
Signature Date / /