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Application For Employment


APPLICATION FOR EMPLOYMENT FORM –
Private and Confidential

*All fields are to be completed

your image
Ref. No:

Position applied for:

Title
Forename Surname
Address:
Postcode:
Tel.(Home): Tel.(Mobile):
N.I. Number:
Current Driving License?
Groups: Expiry date:
Details of endorsements:
Are there any restrictions on you taking up employment in the UK?
(If Yes , please provide details)

Education

Schools/Colleges/University Qualifications Gained Date Gained

Employment History:

(please complete in full and use a separate sheet if necessary)

Dates

from To
Name and Address:
Job Title: Rate of Pay:
Duties
Reason for Leaving
Notice Required:
Current membership of professional bodies (i.e. CIPD, NMC)

Please note any professional bodies you are a member of or are registered with:

Other Employment

Please note any other employment that you would continue with if you were to be successful in obtaining this position.

Leisure

Please note here your leisure interests, sports and hobbies, other pastimes etc.

References

Please note here the names and addresses of two persons from whom we may obtain both character and work experience references one should be from your current or most recent employer.

Name 1
Position
Address
Postcode
Telephone
Email:
May we approach the above prior to interview?
References

Please note here the names and addresses of two persons from whom we may obtain both character and work experience references one should be from your current or most recent employer.

Name 2
Position
Address
Postcode
Telephone
Email:
May we approach the above prior to interview?
General Comments

Please detail here your reasons for this application, your main achievements to date and the strengths you would bring to this post. Specifically, please detail how your knowledge, skills and experiences meet the requirements of this role (as summarised in the person specification).

How did you hear about the vacancy?
Criminal Record

Please note any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974. If none please state. In certain circumstances employment is dependent upon obtaining a satisfactory Disclosure & Barring Certificate from the Disclosure & Barring Service/Disclosure Scotland.

Emergency Contact Details:
Title
Forename Surname
Relationship to you:
Contact address (including postcode):
Home Telephone: Work Telephone:
Personal Mobile: Work Mobile:
Next of Kin (if details different to the above information)
Relationship to you:
Contact address (including postcode):
Home Telephone: Work Telephone:
Personal Mobile: Work Mobile:
General Practitioner’s Details:?
Name Telephone Number:
Postal address (including postcode):
Are there any medical conditions we should know about in case of an emergency? Yes/No
If yes, please give details:
Declaration

(Please read this carefully before signing this application)

1. I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.

2. Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor. I agree that the organisation reserves the right to require me to undergo a medical examination. In addition, I agree that this information will be retained in my personnel file during employment and for up to six years thereafter and understand that information will be processed in accordance with the Data Protection Act.

3. I agree that should I be successful in this application, I will, if , apply to the Disclosure & Barring Service/Disclosure Scotland for a Disclosure & Barring Certificate. I understand that should I fail to do so, or should the disclosure not be to the satisfaction of the company any offer of employment may be withdrawn or my employment terminated.

Signed Date