Confidential. Please type or write in black ink

Job Application Form

It is important for us as employers to know as much as possible about you the applicant.

Complete this form accurately and in full, as it forms the initial stage of our selection.

Post Applied For

Personal

Surname Block letters

Other names

Address

Telephone (home)

/

Telephone (mobile)

Email

Do you require a work permit?

Education, Training & Professional Qualifications

School, college, university, institute, etc. / Dates attended (or period of study if not by attendance) / Qualifications obtained / Date
Present Employment
Present/most recent employer’s name and address
Job title / Present or final salary/wage
Date of appointment / Period of notice required / Leaving date if not now working
Reason for leaving (or for seeking other employment)
Give a brief outline of your responsibilities

Chart

Please draw a chart showing your position in your present or most recent organisation

Previous Employment

Name and address of employers (most recent first) / Job title and brief details of main responsibilities / From / To / Salary/
Wage / Reasons for leaving

Continue on a separate sheet if necessary

Health

Have you been absent from work/college/school/because of illness in the last two years?
If yes, please state the number of days you were absent / Yes/No

Interests

What general interests to you have outside your work?

Experience

Please use this space to give further detailsof your training, experience and other skills in support of your application (additional sheets may be attached as necessary).

Referees

Please give the names and contact details of two referees. Both referees should have known you at work/school/college and one referee should be your present or most recent employer.
Name / Name
Address / Address
Occupation / Occupation
Telephone / Telephone
Email / Email
May we request a reference:
  • at any time
  • only after offer of employment
/ May we request a reference:
  • at any time
  • only after offer of employment

General

Please give details of any criminal convictions you have had, excluding any considered ‘spent’ under The Rehabilitation of Offenders Act 1974 (minor motoring offences should be disregarded).
Data Protection Act 1998
I hereby consent to The Place holding and using data on this application form, for the purposes of administering and supervising my application for employment with The Place. I agree that such data may be made available to those who reasonably need to know the same within The Place. I understand and agree that this data will be kept for up to one year following the recruitment process. In the event I am successful in my application the data will be used for the basis of my personnel record.
To the best of my knowledge the information on this form is correct.

Signature:

Date:

applicationform