CAPITAL

Application Form

Please complete this form in bold letters. Thank you!

Personal Details

Application for employment as: …………………………………………………………………………………………………………..……

Surname: ………………………………………….…………… Other Names: ………………………………………………………….…….

Address: ……………………………………………………………………………………………………………………………………..……..……..

………………………………………………………..…………………………………………………………………………………………………………

Postcode: …………………………………………………………………. Tel (Home): …………………………………………......

Tel (Mobile): ………………………………………………………………. Email: …………………………………………………….…

National Insurance Number: …………………………………..….

Country of Birth: …………………………………..….… Nationality: ……………………………………………………………..…….

Marital Status: …………………………………………… No. of Dependants: ………………………………..…………………..…

Do you have a UK driving licence? Y/N* Endorsements? Y/N* (* Please delete as applicable)

If you have endorsements please give details:

·  How many points do you have? ……………………………………………………….

·  What are the points for? ......

Details of Education

Subject / Year Passed / Level e.g. GCSE/A level/Degree / Grade

Details of any additional training courses: ……………………………………………….………………………………………………

…………………………………………………………………………………………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………..

Employment History in the last 5 years:

1.  Present/Last Employer: ……………………………………………………………………………………………………………………...

Address: …………………………………………………………………………………………………….….………………………………………..

……………………………………………………………………………………………………………………………………………….…………………

Postcode: ………………………………………. …… Contact name: …………………………………………………………......

Tel No: …………………………………………….. ….. Fax/Email: ……………………………………………………………………

Your Job Title: ………………………………………………………………………………………………………………………………………….

Duties: ………………………………………………………………………………………………………………………………….……..…….………

…………………………………………………………………………………………………………………………………………………..….……………

Date employed: From: …………………………… To: ……………………………………..…………………………………………..

Reason for leaving: ………………………………………………………………………………………………….………………………………

……………………………………………………………………………………………………………………………………………...……………………

Salary: …………………………………………………….. … Notice Period: ………………………………………………….…………….

1. Previous Employer: ………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………...………………

Postcode: ………………………………………………… Contact name: ………………………………………………………………..

Tel No: …………………………………………….. ……. . Fax/Email: …………………………………………………………………….

Your Job Title: ……………………………………….....………………………………………………………………………………………………

Duties: …………………………………………………………………………………………………………………………………………………….…

……………………………………………………………………………………………………………………………………………………………...……

Date employed: From: …………………………… To: …………………………………………………………………………………….

Reason for leaving: …………………………………………………………………………………………….……………………………….…..

……………………………………………………………………………………………………………………………………………….…………..………

Salary: ………………………………………………

2. Previous Employer: ………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………...………………

Postcode: ………………………………………………… Contact name: ………………………………………………………………..

Tel No: …………………………………………….. ……. . Fax/Email: …………………………………………………………………….

Your Job Title: ……………………………………….....………………………………………………………………………………………………

Duties: …………………………………………………………………………………………………………………………………………………….…

……………………………………………………………………………………………………………………………………………………………...……

Date employed: From: …………………………… To: …………………………………………………………………………………….

Reason for leaving: …………………………………………………………………………………………….……………………………….…..

……………………………………………………………………………………………………………………………………………….…………..………

Salary: ………………………………………………

3. Previous Employer: ………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………...………………

Postcode: ………………………………………………… Contact name: ……………………………………………………………….

Tel No: …………………………………………….. ……. . Fax/Email: …………………………………………………………………...

Your Job Title: ……………………………………….....……………………………………………………………………………………………..

Duties: …………………………………………………………………………………………………………………………………………………….…

……………………………………………………………………………………………………………………………………………………………...……

Date employed: From: …………………………… To: ……………………………………………………………………………………

Reason for leaving: …………………………………………………………………………………………….……………………………….…..

……………………………………………………………………………………………………………………………………………….…………..………

Salary: ………………………………………………

If you have been unemployed in the last 3 years -
What you did? E.g. Claim Job Seekers Allowance/Attend Training Courses
Please give dates as well
What you did:
Dates: / What you did:
Dates:
If you were self employed
From: To:
Name & Address of Business:
Type of Business:
HMRC Ref. No. / From: To:
Name & Address of Business:
Type of Business:
HMRC Ref. No.

Please tell us why you applied for this job and why you think you are the best person for the job.

Professional Character References

Please give the names and addresses of 2 character referees who have known you for at least 3 years. They must not be related to you.

1. Name of Referee: ……………………………………………….. Job Title: ………………………………..…………………………

Address: …………………………………………………………………………………………………………….…………………….……….…….

Postcode: …………………………………………………………………………………………………..…………..………….…………….……..

Tel No/Email: ………..…………………………………..…………………………………………………………………………………………….

2. Name of Referee: ……………………………………………….. Job Title: ………………………………..…………………………

Address: …………………………………………………………………………………………………………….…………………….……….…….

Postcode: …………………………………………………………………………………………………..…………..………….…………….……..

Tel No/Email: ………..…………………………………..…………………………………………………………………………………………….

Security Clearance Information:

As many of our contracts require government clearance all applicants will need to supply the following additional information to be considered for the position.

Your Father
Relationship if not natural father:
Surname now:
Surname at Birth:
All Forenames:
Date of Birth:
Town, County & Country of Birth:
Present Nationality:
Former Nationality:
If Naturalised, Number & Date of Certificate:
If non UK National, Date of Taking up Permanent Residence in UK:
Full Permanent Address:
Date moved to this address:
If deceased, please give date of death:
Your Mother
Relationship if not natural mother:
Surname now:
Surname at Birth:
All Forenames:
Date of Birth:
Town, County & Country of Birth:
Present Nationality:
Former Nationality:
If Naturalised, Number & Date of Certificate:
If non UK National, Date of ~Taking up Permanent Residence in UK:
Full Permanent Address:
Date moved to this address:
If deceased, please give date of death:

A 5 years address history:

Please provide all addresses you have lived at in the last five years.

Address……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………Post Code...... ………………………..

From: (dd/mm/yy)………………………….. To: (dd/mm/yy)………………………………

Address……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………Post Code...... ………………………..

From: (dd/mm/yy)………………………….. To: (dd/mm/yy)………………………………

Address……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………Post Code...... ………………………..

From: (dd/mm/yy)………………………….. To: (dd/mm/yy)………………………………

Address……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………Post Code...... ………………………..

From: (dd/mm/yy)………………………….. To: (dd/mm/yy)………………………………

Address……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………Post Code...... ………………………..

From: (dd/mm/yy)………………………….. To: (dd/mm/yy)………………………………

Important Information (* Please delete as applicable)

Have you ever been convicted of a criminal offence? Y/N* (* Please delete as applicable)

(Declaration subject to the Rehabilitation of Offenders Act 1974)

Do you hold a current valid UK passport? Y/N*

If NO please state type of visa and expiry date:

………………………………………………………………………………………………………………..

Can you supply proof of your current address in the form of a utility bill? i.e. Gas, electricity, water, etc. – Please circle all bills which you can supply:

Gas Electricity Water Council Tax

Can you supply one of the following documents? Y/N*

If YES Please circle which one you can supply.

·  3 pay slips from the last 6 months

·  P60 from last financial year

·  P45 issued no more than 6 months ago

Do you have any serious illness or disability which could prevent you from working regularly?

Y/N*

If yes, please give details:

……………………………………………………………………………………………………………………………………………...……………………

The Employee is required to provide original copies of all documents which prove his/her right to work in the UK. If any of the above is not satisfactory any offer of employment will be withdrawn.

I confirm that to the best of my knowledge the above information is correct. I accept that providing deliberately false information may cause my application to be rejected or could result in my dismissal.

Applicant’s Signature: ……………………………….……….……… Date: ….……………………….……………………………..

For Office Use Only

Once you have completed the form please return it to:

Alternatively you can send it by post to:

Human Resources Department

Capital Computer Care

Ironstone House

205-213 High Street

Beckenham

Kent BR3 1AH

...cleaning technology