EDUCATION & TRAINING (Please Use an Additional Sheet If Necessary)

Application Form

PLEASE COMPLETE THE FOLLOWING AND RETURN BY E-MAIL OR POST or Lauren Forsythe, Musgrave Retail Partners NI, 1-19, Dargan Drive Belfast BT3 9JG.

POSITION APPLIED FOR:
SURNAME / FIRST NAMES
ADDRESS / CONTACT

/ HOME
(If different)

TELEPHONE / HOME / WORK
(with discretion)

EDUCATION & TRAINING (please use an additional sheet if necessary)

SECONDARY SCHOOLS / FROM / TO / EXAMINATIONS & RESULTS
FURTHER EDUCATION & TRAINING / FROM / TO / COURSES & QUALIFICATIONS

EMPLOYMENT HISTORY

List below your past & present employment, beginning with the most recent (please use additional sheet if necessary)

FROM / TO / EMPLOYER’S NAME & ADDRESS / DESCRIPTION OF ROLE / REASON FOR LEAVING

Application Form

TIMES AVAILABLE (Please place an “X” in the relevant boxes)

Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
MORNING
AFTERNOON
EVENING
ALL

HOBBIES & INTERESTS

REFEREES

PLEASE GIVE THE NAME, ADDRESS & CONTACT NUMBER FOR TWO PEOPLE WHO ARE IN A POSITION TO GIVE A REFERENCE ON YOUR PROFESSIONAL/WORK ABILITY (We will not contact your current employer without your knowledge)
NAME / NAME
ADDRESS /
ADDRESS
TEL NO. / TEL NO.
COMPANY / COMPANY
POSITION / POSITION

ARE THERE ANY COMMENTS YOU WISH TO MAKE IN SUPPORT OF YOUR APPLICATION

The foregoing information is a correct summary of my experience and qualifications

SignedDate

If you are under 18 years of age, please ask your parent or guardian to sign and date below:

SignedDate

«Code»

MONITORING INFORMATION FORM

The information that you are asked to supply will be treated in the strictest confidence and protected from misuse.

Centra monitors the applications it receives for jobs in order to ensure that its recruitment practices promote equality of opportunity. This information will be used only for the purpose of monitoring our equality of opportunity in employment policy.
Please indicate your religion, or the religion to which you would be perceived to belong, by ticking the appropriate box below. You should note that it is an offence, under the Fair Employment (NI) Act 1989, to give false information to an employer who is seeking information from job applicants.
I am a member of the Protestant Community
I am a member of the Roman Catholic Community
I am a member of neither the Protestant nor the Roman Catholic Community
Gender: Male
Female
Under the Disability Discrimination Act 1995, a person is considered to have a disability if he/she has a physical or mental impairment which has substantial and long-term adverse effect on his/her ability to carry out normal day-to-day activities. It is the Company's policy to recruit on merit only and having a disability will not affect your employment prospects in any way.
Do you consider that you meet this definition of disability? YES NO
If yes, please state the nature or effects of your disability:
What is your date of birth?
d d / m m / y y

Please return this completed form to the Store Manager along with your application form to the address at the top of the form. Thank you for your co-operation.