CONFIDENTIAL

Please complete this form in black ink or type so that it may be photocopied.

Please note, an incomplete application form may jeopardise the progression of your application.

Application for the post of:
Where did you hear about this position:
PERSONAL DETAILS
Title / Mr / Mrs / Miss / Ms / Dr / Other (please specify)
Surname
Forename(s)
Address / Postcode
Email address
Telephone numbers / (Home) / (Mobile)
Best time to Contact:
Do you hold a full valid UK Driving Licence? / YES / NO
Please give details of any endorsements:
Have you any criminal convictions, which are not ‘spent’ convictions under the rehabilitation of offenders act 1974 / YES / NO
If yes please state the date(s) of conviction(s) and the nature of offense(s)
Are you facing any criminal prosecution’s: / YES / NO
If yes please state the details:
WORK EXPERIENCE AND RELEVENT EMPLOYMENT
Please list chronologically starting with last employer
Position Held and principle duties performed / Name and address of employer / From and To dates / Reasons for leaving
EDUCATION AND QUALIFICATIONS
Name of University where Veterinary degree obtained:
Year of Graduation:
Name of Degree obtained:
Any other Post Graduate Qualifications:
MEMBERSHIP OF PROFESSIONAL BODIES
Name of Body / Registration Type
CPD AND TRAINING
Please provide a copy of your CPD record.
Details of any other training relevant to the post:
OTHER QUESTIONS
What is your understanding of the client - pet bond and why is this important:
Please tell us why you applied for this position and why you think you are the best person for the job:
What are your interests outside work:
REFEREES
Please give details of two people able to provide references relating to your experience and suitability to this post (not friends or family). The first reference should be your current or most recent employer.
Reference 1 / Reference 2
Name / Name
Address and Postcode / Address and Postcode
Email address / Email address
Tel No / Tel No
Capacity in which known / Capacity in which known
May we approach if called for interview / YES / NO / May we approach if called for interview / YES / NO

By providing the information contained within this application form, your consenting to its use for the purpose of processing your application, assessing your performance in the future should your application be successful and monitoring the efficiency of our recruitment and other employment procedures. Individuals have the right of access to personal data concerning themselves.

Your details may be retained on file for a period of up to six months for any suitable vacancies that may arise. Please confirm whether or not you wish us to retain your details for this purpose.

YES / NO

Lanes Vets is an Equal Opportunities employer and intends that no job applicant or employee shall receive less favourable treatment nor be disadvantaged by any condition which cannot be shown to be justifiable.

DECLARATION
I certify that the information given on this form is correct. I understand that any willful omission or falsification may lead to the disqualification of this application or dismissal if appointed to the post applied for.
Signed: / Date:

Please return your completed application to: Practice Manager, Lanes Vets Ltd, Leachfield Industrial Estate, Green Lane West, Cabus, Garstang PR3 1PR.

Candidates invited to interview are asked to bringProof of eligibility to work in UK (passport / birth certificate / etc.), Driving licence, proof of qualifications, and any certificates.

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