Job Application Form

Please ensure this application is returned to HR Department, Musgrave Retail Partners NI, 1-19 Dargan Drive, Belfast Harbour Estate, Belfast BT3 9JG by 5.00pm on the closing date specified in the advertisement. Or alternatively email your completed form to

Your application cannot be considered if it is late or if it is accompanied by unrequested material such as references and/or your CV.

POSITION APPLIED FOR:
SURNAME / FIRST NAMES
TITLE / MR/MRS/MS/MISS (delete as appropriate) / National Insurance Number:
ADDRESS / CONTACT


/ HOME
(If different)


TELEPHONE / HOME / MOBILE

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

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

Job Application Form

EMPLOYMENT HISTORY

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

Employer Name &
Nature of
Organisation / Career Narrative (key duties, reporting
structures etc)
Job Title
Dates From & To
(month & year)
Employer Name &
Nature of
Organisation / Career Narrative (key duties, reporting
structures etc)
Job Title
Dates From & To
(month & year)
Employer Name &
Nature of
Organisation / Career Narrative (key duties, reporting
structures etc)
Job Title
Dates From & To
(month & year)

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, TO INCLUDE ONE WHO 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
DO YOU HAVE ANY CRIMINAL CONVICTIONS, WHICH ARE NOT REGARDED AS SPENT UNDER THE REHABILITATION OF
OFFENDERS (NI) ORDER 1978? YES/NO
IF YES, PLEASE PROVIDE DETAILS OF UNSPENT CONVICTIONS BELOW


SPECIAL ARRANGEMENTS
IF YOU HAVE A DISABILITY WHICH WOULD REQUIRE SPECIAL ARRANGEMENTS TO BE MADE IF
CALLLED FOR AN INTERVIEW, PLEASE SPECIFY THE ASSISTANCE REQUIRED BELOW


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.

I understand that any false information given may result in any job offer being withdrawn or employment terminated.

Signed Date

MONITORING INFORMATION FORM

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

SuperValu 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 above address with you application form.

Thank you for your co-operation.