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Site
Applied For |
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Job Applied For |
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| Full
Name |
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| Address |
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| Postcode |
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| Email
Address |
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| Date
Of Birth |
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| Contact
Telephone Numbers Day & Night |
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| National
Insurance Number |
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| Are
there any restrictions on you taking up employment in the UK |
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| Education
History |
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| Employment
History, Dates & Reason For Leaving |
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| Please
note any other employment you would continue if successful with this
application |
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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 basic disclosure from the Criminal
Records Bureau/Scottish CriminalRecordsOffice.
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Do you have a physical or
mental impairment which has a substantial and long term effect on
your ability to carry out day to day activities? |
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Please specify any special
arrangements for work associated with any impairment.
Please specify any special
arrangements you will need to attend an interview. |
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Please list any diseases,
disorders, allergies, muscular or musculoskeletal injuries from which you
have suffered or do suffer. |
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Please detail any form of medicine, drugs
or treatment you are currently and/or regularly receiving.
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| Please
list all absences from work in the past 12 months and the reasons for such
absences. |
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| Please
provide Names, Addresses & contact phone Numbers for 2 references |
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Declaration
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. Shouldwe 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 right 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 required, apply to the Criminal Records
Bureau/Scottish Criminal
Records Office for a basic disclosure. I understand that should I fail to
do so, or should the disclosure not be to the
satisfaction of the companyany offer of employment may be withdrawn or my
employment terminated.
By Clicking On
Submit, you are bound by the terms of the Declaration Above
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