Application for Employment

Thank you for your interest in working for CLIC Sargent. The information you provide on this form will be used to assess your suitability for the particular role you are applying for. Please ensure you read the accompanying guidance notes before completing this form as they contain important information on completing and submitting your application. The guidance notes can be downloaded from the Latest Opportunities section of our website, or can be requested from our HR department on 0208 752 2901.

1. Position Details

Position applying for:

Location:

Where did you hear about this vacancy?

2. Personal Details

Surname:First name/s:

Any previous names used?

Address:

Post code:

Daytime contact number: Mobile number:

Email address:

3. Other Information

Notice period to current employer (if applicable):

Do you hold a full driving licence (delete as appropriate): NA for role/Yes/No

Do you have a clean driving licence (delete as appropriate): NA for role/Yes/No

If no, please give details:

Do you have access/use of a vehicle (delete as appropriate): NA for role/Yes/No

Are you in a relationship with a CLIC Sargent employee? Yes/No

If yes, please give details:

Have you applied for employment with CLIC Sargent before? Yes/No

If yes, please give details:

4. Education

From / To / School, College or University / Qualification / Subjects / Grades

5. Training and Development

From / To / Course provider / Course title / Subjects

6. Registration and Membership of Professional Bodies

Name of body / Type of membership / Date obtained

7. Work History – paid or voluntary covering at least the last five years

Continue on a separate sheet if necessary

Job title:

Organisation:

Duties/Responsibilities:

Achievements:

Period of employment/volunteering: From (month and year) to (month and year)

Salary/Wage (if applicable):

Reason for leaving:

Job title:

Organisation:

Duties/Responsibilities:

Achievements:

Period of employment/volunteering: From (month and year) to (month and year)

Salary/Wage (if applicable):

Reason for leaving:

Job title:

Organisation:

Duties/Responsibilities:

Achievements:

Period of employment/volunteering: From (month and year) to (month and year)

Salary/Wage (if applicable):

Reason for leaving:

Job title:

Organisation:

Duties/Responsibilities:

Achievements:

Period of employment/volunteering: From (month and year) to (month and year)

Salary/Wage (if applicable):

Reason for leaving:

Job title:

Organisation:

Duties/Responsibilities:

Achievements:

Period of employment/volunteering: From (month and year) to (month and year)

Salary/Wage (if applicable):

Reason for leaving:

8. Gaps (if any) in your work history, covering at least five years

Continue on a separate sheet if necessary

From (month and year) to (month and year):

Details:

From (month and year) to (month and year):

Details:

From (month and year) to (month and year):

Details:

9. Experience, Achievements and Relevant Skills

Please explain why you are applying for this vacancy and how you feel your transferable skills, relevant experience and achievements match the requirements for this role. Please make particular references to the job description and person specification for this role.

10. Work References - to coverat least the last five years for services positions (three years for all other positions)

Continue on a separate sheet if necessary

Organisation:

Referee’s name and job title:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

Dates you worked for this organisation/individual: From (month and year) to (month and year)

Organisation:

Referee’s name and job title:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

Dates you worked for this organisation/individual: From (month and year) to (month and year)

Organisation:

Referee’s name and job title:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

Dates you worked for this organisation/individual: From (month and year) to (month and year)

Organisation:

Referee’s name and job title:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

Dates you worked for this organisation/individual: From (month and year) to (month and year)

11. Character References – to cover gaps in your work history (if any) or as a second referee (if required)

Continue on a separate sheet if required

Referee’s name and occupation:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

For gaps in your work history – this person can verify you were not working: from (month and year) to (month and year)

Referee’s name and occupation:

How are you known to this person?

Address:

Post code:Phone number:Fax number:

Email address:

For gaps in your work history – this person can verify you were not working: from (month and year) to (month and year)

12. Work Eligibility

Are you eligible to work in the UK (delete as appropriate): Yes/No

Do you have limitations on your eligibility to work in the UK (delete as appropriate): Yes/No

If yes, please give details:

13. Special Consideration

Please outline any special arrangements that may need to be to allow you to attend an interview and/or skills test if invited

14. Availability for Interview

Are you available on the interview dates (if advertised)? Yes/No

If no, please state which days/dates/times you are NOT available:

15. Accompanying Information

I have enclosed/attached the Rehabilitation of Offenders Declaration form: Yes/No

Please note, we cannot process your application without this Declaration

I have enclosed/attached the Equal Opportunities Monitoring form:Yes/No

I have enclosed/attached additional information/continuation sheets:Yes/No

If yes, number of additional pages used:

I have enclosed/attached a CV and/or additional supporting statement:Yes/No

16. Declaration

If certify that the information given on this form is correct and understand that any misleading information or deliberate omissions will be regarded as grounds for withdrawal of an offer, or if appointed grounds for subsequent disciplinary actions which could lead to dismissal.

I authorise CLIC Sargent to obtain references to support this application once an offer of employment has been made and accepted and release CLIC Sargent from any liability caused by giving and receiving information.

Signed (NA if emailing):

Print name:Date:

Data Protection Act

Your personal details will be treated as confidential and kept for no longer than necessary. If your application is successful your application, Equal Opportunities Monitoring form and Rehabilitation of Offenders Declaration will become part of your personal records. Some of the information may be held on a computer database.

Continuation Sheet (if necessary)