Do You Have Any Health Problems Relevant To

ASHLEIGH CONTRACTS

(Ashleigh N.I. Ltd)

30c Ballygelagh Rd, Kircubbin, Newtownards, Co. Down BT22 1AE

Tel & Fax: 028 4277 2781 Email:

APPLICATION FOR EMPLOYMENT

Position Applied For:

Surname ……………………….…… First Names………………………………………….

Address…………………………….……………………………………………..…….……

…………………………………………………………………………………………...…..

Telephone No …………………………….………………

Date of Birth ……..………………

Marital Status………….……... Dependants…………………………....……....

QUALIFICATIONS & CERTIFICATES ATTAINED

N.B Please list starting with most recent Qualifications

Dates / College of F.E / Schools / Subjects / Grades / Certificates Attained

PREVIOUS EMPLOYMENT SUMMARY

N.B Please list starting with most recent Employment

FROM / TO / COMPANY / SALARY / RELEVANT EXPERIENCE & REASON FOR LEAVING

HEALTH & SAFETY TRAINING

N.B Please list starting with most recent Training

DATES / COURSE TITLE / CERTIFICATE ATTAINED / TRAINING PROVIDER

Do you have a driving licence? Yes No

Have you ever been convicted of a motoring offence? Yes No

If Yes, please give details …………………………………………………………………………………………...…

…………………………………………………….………………………………………..

Do you have use of a car? Yes No

Do you have any health problems relevant to

the post you are applying for? Yes No

If yes, please give details…………………….…………….……………………………..

…………………………………………………………….………………………………

The nature of works carried out by Ashleigh Contracts will involve working tidal hours and / or working away from home for individual contracts. Are you willing to undertake the above conditions of employment where necessary?

Yes No

OTHER RELEVANT INFORMATION…………………………..…….……………….

……………………………………………………………………………………………….

…………………………………………………………………………….………………….

…………………………………………………………………………….…………………

Please provide details of a minimum of two Referees who may be contacted if necessary – at least one from previous employment:

1 …………………………………………….. 2 …………………………………………….……

Position:………………………………………. Position:……………………………………….….

…………………………………………….. …………………………………………….……

Tel: ………………………………………….. Tel: ..………………………………………….……

3 …………………………………………….. 4 …………………………………………………

Position:………………………………………. Position:……………………………………….….

…………………………………………….. …………………………………………………

Tel: ………………………………………….. Tel: ..………………………………………………

Signature of Applicant: ………………………………..

Date:………………

Please return completed Application Form to:-

Mrs Maureen Trousdale

Ashleigh Contracts

30c Ballygelagh Rd

Kircubbin

NEWTOWNARDS

Co Down

BT22 1AE

Tel:028 4277 2781

Fax: 028 4277 2685

Email:

Website:

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