A1 Support Application Form
EMPLOYEE APPLICATION FORMCandidates are required to complete all sections of the application form in black ink or typescript.
Please read all instructions, job description and person specification prior to completing this form.
Post Applied For: / Establishment:
Where/How did you hear about the vacancy? / Preferred Employment (delete as appropriate):
Full Time / Part Time / Sessional
Personal Details
Surname: / Title:
Other Name(s):
Address: / Postcode:
Telephone number: / Home: Mobile:
Work:
Email:
D.O.B.
Are you entitled to work in the UK?
Do you need a Visa to work in the UK? (Please provide details)
National Insurance Number
Do any of your family members currently work for A1 Support?
Do you hold a current full driving licence? (Manual / Automatic)
Does your licence have penalty points or Endorsements?
If yes, please give details: -
References
Please provide details of at least three referees who have knowledge of your work, one of whom should be your current/most recent employer. References must be from a person who has line managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.
Full Name:
Do contact now / Do not contact now* / Full Name:
Do contact now / Do not contact now*
Job Title: / Job Title:
E-mail address: / E-mail address:
Full Address (Including Company Name):
Post Code: / Full Address (Including Company Name):
Post Code:
Telephone No. / Telephone No.
Company you worked with referee at
if different from company above: / Company you worked with referee at
if different from company above:
PERSONAL REFEREE
Full Name
Do contact now / Do not contact now*
Job Title
E-mail address
Full Address ( Including Company Name)
Post Code
Telephone No.
*If you do not wish us to approach one or both of your referees prior to interview, please highlight the “Do not Contact Now” selection above and give a reason below:
Education
Qualifications Gained at School
Name of school attended:
Qualification / Subject / Date Gained / Grade
Further and Higher Education
Please provide details of any courses for which a certificate, eg SVQ, HNC, HND, degree or diploma was awarded.
Name of Institute/College / Qualification / Subject / Date Gained
Membership of Professional Bodies (Current Membership only)
Name of Awarding Body / Institution / Class of Membership / Date Awarded
Employment
Present or most recent employment
Company Name:
Full address and contact details / Job title:
Date started:
Date left (if applicable): -
Salary and other benefits:
Nature of business:
Reasons for leaving:
Main duties and responsibilities:
Please provide details of your past employment history to date, starting with your most recent first, accounting for any periods of time not spent in further education or employment.(Continue on separate sheet if necessary). Please note that references may be sought from any of your previous employers
Name and address of Employer / Your Job Title / Your Main Responsibilities / Duration of employment (from / to) / Reason for leaving
Mandatory Additional Information
(please continue on a separate sheet if necessary)
1. Please state give details of any relevant skills you will bring to the post applied for. This can include training, qualities, achievements at work and non-work related or voluntary experience. Please refer to the skills outlined in the person specification supplied.
2. Please give reasons for applying for this post. We are particularly interested in your reflections on your own personal history and the experiences which have shaped you.
Records Check
Have you been convicted of any criminal offence (including driving offences)?
If yes, please give details: -
Are you presently the subject of a criminal investigation?
If yes, please give details: -
The disclosure of a criminal record will not debar you from appointment unless the selection panel considers that the conviction renders you unsuitable for appointment. However, this post is exempted employment within the terms of the Rehabilitation of Offenders Act 1974 (Exemptions) Order, as amended. You are therefore required to declare any convictions, whether or not they would, in terms of the Act, be classed as spent.
Failure to disclose important information may disqualify you from appointment or lead to summary dismissal.
If selected for the position, we will check your details against criminal records held by the Police, prior to an offer of employment.
Disclosure
Please be aware that any undisclosed information that comes to light in the future could have a bearing on your employment with A1 Support Ltd and may lead to dismissal.
Final Checklist
Item / Completed and Included?
Application Form
Health Declaration
Equality and Diversity Monitoring Form
Signed Declaration
COMPLETED APPLICATION FORMS SHOULD BE RETURNED TO:
A1 Support Limited
66 Finnemore Road
Bordesley Green
Birmingham
B9 5XT
If you return your application electronically and are selected for interview, you will be asked to sign a hard copy of your application form.
Declaration IMPORTANT (Please read carefully before signing)
Data ProtectionIn accordance with the Data Protection Act of 1988, the information entered onto this form and any accompanying papers will be used to assess your suitability for the post and will not be released to anyone who does not require it for this purpose. If you are employed the information you have provided on this form will be used for personnel record and payroll purposes, otherwise the information will be destroyed six months after the post has been filled.
You have the right to require us to correct any inaccuracies in your information.
I certify that to the best of my knowledge all statements given by me on this form are true and accurate. I understand and accept that if it is subsequently discovered that any statement is false or misleading or that I have withheld information, my employment may be terminated without notice.
Signature / Date
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