Confidential Application for Employment

To apply for any position advertised on our website, please complete the form below making sure it is accurate and complete. An accurate email address is required for us to communicate the results of your enquiry.

Personal Information Surname
Forename(s)
Address
Postcode
Telephone
Mobile
Evening
Email Address
National Insurance No

Employment Details Position Applied For
If offered this position, will you work in any other capacity?
What date will you be available to start work?
Would you be prepared to work Overtime?

Health Are you in good health? Yes No
Have you visited your doctors in the last 2 years? Yes No
If yes, please give details
Are you receiving any medical treatment? Yes No
If yes, please state what?
Do you have any form of disability? Yes No
If yes, please give details of how we can help you overcome these limitations?
Please list any absence from work in the past 12 months and state the reasons for them.

General Information Do you hold a Driving Licence? Yes No
If yes, do you have any Endorsements? Yes No
If yes, please give details?
Do you have any holiday booked? Yes No
If yes, please give details?
Please note any criminal convictions except those "spent" under the Rehabilitation Of Offenders Act. If you have none please state "None".
Are you a UK or European Union National? Yes No
If you are not, please attach the relevant documentation stating your eligibility for employment in the UK?

Hobbies and Interests Please give details of hobbies and interests

Education School/College/University Qualifications (Subject and Results)
Please state any skills you have, or courses you have attended relevant to the position you have applied for
Do you speak or read a foreign language (please give details)

Work History Voluntary, Unpaid, etc Name & Address of Employer (inc Telephone)
Starting/Leaving Dates
Rate Of Pay
Job Title
Title Of Supervisor/Manager
Details of Duties/Responsibilities
Reason For Leaving
Previous Name & Address of Employer (inc Telephone)
Starting/Leaving Dates
Rate Of Pay
Job Title
Title Of Supervisor/Manager
Details of Duties/Responsibilities
Reason For Leaving
Please state any reason for any gap in Employment
Have you ever worked for this Company before? Yes No
If yes, please give details including dates

References Please give the deatils of two people to whom we may contact for references one of which should be your last or current employer. If you do not want us to contact them, unless we offer you the position please tick the box.
Name
Position
Name Of Company
Address
Telephone
Length of Time Known
Name
Position
Name Of Company
Address
Telephone
Length of Time Known

Declaration It is understood and agreed that any misrepresentation by me on this application form will be sufficient cause for cancellation of this application and/or termination from the employer's service if I am employed.

I give the employer the right to investigate all of the references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organisations for furnishing such information.