Job Position applied for / Reference No
First Name *
Surname *
DOB *
Address *
Postcode *
Email *
Home Tel
Mobile
Do you hold a current driving licence? Do you hold a current driving licence? Yes No
Type Type Full Driving License Provisional Driving Licence
What categories does it cover?
Is it free of endorsements?
Please give details of any points or driving convictions, including any pending convictions. (Any declarations are subject to the Rehabilitation of Offenders Act 1974 (as amended).
Please give details
Are there any adjustments that may be required to be made should you be invited for interview?
If Yes, please give details
Please indicate two people who can provide a reference for you – one of whom should be your present or most recent employer.
Full Name
Email
Number
Company Name
Occupation/Relationship to you
Full Address
Full Name
Email
Number
Company Name
Occupation/Relationship to you
Full Address
I give permission to contact my reference prior to an offer of employment being made.
Please give details of all jobs held including part-time and unpaid work, starting with your current or most recent employer. Please explain any gaps.
Name & Full Address of Employer / nature of business
Job title(s); key responsibilities & key achievements
Reason for leaving & Date of leaving
Name & Full Address of Employer / nature of business
Job title(s); key responsibilities & key achievements
Reason for leaving & Date of leaving
Name & Full Address of Employer / nature of business
Job title(s); key responsibilities & key achievements
Reason for leaving & Date of leaving
Name & Full Address of Employer / nature of business
Job title(s); key responsibilities & key achievements
Reason for leaving & Date of leaving
If any of the above positions involved working with vulnerable adults or children, please indicate below contacts details of someone who can verify your reasons for leaving .
Name of Employer
Contact & position within the company
Telephone Number
Please name any awarding institute or professional body in full and include attainment level specifying relevant grades or grade of membership.
Please include any courses, membership, voluntary work or responsibilities you have obtained that you consider relevant, with outcomes where applicable.
Languages spoken/written (please indicate level of competence)
Computer literacy (please specify software and level of competence)
Do you have armed service/public duty commitments? (e.g. are you a member of the TA/ a JP/ a councillor, etc.)
Do you have armed service/public duty commitments? (e.g. are you a member of the TA/ a JP/ a councillor, etc.) Please give details
How/where did you hear about this vacancy?
Have you made an application to this Company before?
Are you currently eligible for employment in the UK?
Please state what documentation you can provide 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
You will be asked about any criminal records, and the Company’s commitment to undertake criminal records checks with the Disclosure and Barring Service if you are invited for interview .
The information that you provide on this form and that obtained from other relevant sources will be used to process your application for employment. The personal information that you give us will also be used in a confidential manner to help us monitor our recruitment process.
If you succeed in your application and take up employment with us, the information will be used in the administration of your employment with us and to provide you with information about us or a third party via your payslip. We may also use the information if there is a complaint or legal challenge relevant to this recruitment process. We may check the information collected, with third parties or with any other information held by us. We may also use or pass to third parties, information to prevent or detect crime, to protect public funds, or in other ways as permitted by law.
By signing this application form we will be assuming that you agree to the processing of sensitive personal data (as described above), in accordance with our registration with the Information Commissioner.
You will be asked about any criminal records, and the Company’s commitment to undertake criminal records checks with the Disclosure and Barring Service if you are invited for interview .
I declare to the best of my knowledge and belief that all particulars I have given in all parts of this application form are complete and true. I understand that any false declaration or misleading statement or a significant omission may disqualify me from employment and render me liable to dismissal. I understand that any job offer is subject to references, checks on relevant qualifications, employment eligibility and criminal convictions (if this is required for the role), a probationary period and (if the Company believes it appropriate) a medical report, all of which must be deemed by the Company as satisfactory.
Yes I Agree / understand all details *
Please the Criminal Records Disclaimer – Click Here
I have read & understood the Criminal Records Disclaimer *
