Title of Post Applied for: Closing Date:

PERSONAL DETAILS

Name / Title (Mr/Mrs/Miss/Ms)
Address
Postcode
Telephone No. (Home) / Mobile Phone No
E-mail address / Telephone (Work*)
Can you be contacted at work? / Do you wish to be contacted via e-mail?

*Calls to work numbers will be made discreetly

Details of Secondary / Further Education

Please note that the Company may ask to see your original certificates.

Dates / School/College/University / From - To / Qualifications Gained

Professional Qualifications / Membership of Professional Bodies

Awarding body / Grade of Membership / Full Details of Professional Qualifications / Date attained

Present / Most Recent Employment Details

Provide details as to the nature of your work including responsibilities, skills and attributes that are relevant to this application.

Employers Name
Address / Job Title
Date Appointed
Date Left (if applicable)
Reason for Leaving
Latest Salary
Length of Notice
Summary of main duties / purpose of job

Previous Employment (starting with the most recent)

From / To / Employer and Position Held / Final Salary / Reason for Leaving

References

Please give two referees who can comment on your professionalism / work ability, one of whom should be your present / most recent employer. If without two previous jobs (or unable to do this) please provide, as appropriate, the names of two educational or personal referees (though not ones related to you).

a) Present / Most Recent Employer / b) Second Referee
Name / Name
Job Title / Job Title
Address
Postcode / Address
Postcode
E-mail Address / E-mail Address:
Telephone No / Telephone No

References will normally be taken up for shortlisted applicants. Please tick the appropriate box if this is not convenient:

Reference a) Reference b)

All appointments will be subject to the satisfactory receipt of references.

Relevant Experience / Skills / Abilities

Please give details of any achievements, career plans or particular areas of work experience, which you feel are most relevant to this post.

Supporting Information

Please use this section to explain why you are applying for the job, concentrating on how your experience, training and personal qualities match the requirements of the person specification. Please include any skills, knowledge and experience that you have gained through voluntary or unpaid work, community activities or through domestic and family experience, which you think may be relevant to the requirements of the job. Please continue on a separate sheet if necessary.

Interests / Leisure Activities

Other Information

Are you currently eligible for employment in the UK?
Please state what documentation you can provide in order to demonstrate this?
(e.g. British passport / European Economic Area Identity Card / Full Birth Certificate / Passport or travel document showing an authorisation to reside and work in the UK).
Do you have a current driving license?
If yes, please specify type (motor car/HGV, etc):
Is your driving license free of endorsements?
If no, please give details of any points or convictions, including any pending convictions?
How and where did you hear of this vacancy?
Have you made an application to the company before?
If yes, please give details:

Rehabilitation of Offenders

Have you any convictions which are not regarded as “spent” Under the Rehabilitation of Offenders Act 1974?
If “yes”, describe the offence and date of conviction:
Failure to disclose any convictions which are not “spent” may render you liable for dismissal.

Disabled Applicants

Applications from disabled candidates are welcomed, and the organisation will make every effort to ensure a fair selection process.

If you have a disability please detail any special requirements or reasonable adjustments that would support you with the recruitment and selection process.

I certify that the details on all pages of this form are true to the best of my knowledge and understand that a false declaration or relevant omission could result in my subsequent dismissal, if appointed. I understand that any job offer is subject to references, checks on relevant qualifications, employment eligibility, criminal convictions, and (if the company believes it appropriate) a medical report, all of which must be deemed satisfactory by the company.

Signed Date

Data Protection

The information you supply on the application form will be used to assess your suitability for the post applied for. These details will only be disclosed to those persons involved in the selection process or Personnel administration.

Should you be successful, certain details from this form may be checked, and data matched to help prevent fraud. Some of the information will be entered into the Personnel Computer System, which will allow 3SDL Ltd to administer your employment. This form will then be placed into your Personnel file and processing will take place in accordance with the provisions of the Data Protection Act 1984 and 1998.

Please be assured that 3SDL Ltd will protect your information, and treat it as confidential at all times.

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