Application for Employment

Application for:

(Job Title)

1. Personal Details (PLEASE USE CAPITAL LETTERS THROUGHOUT)

Current Surname:
Forename(s):
Address:
Address:
Date (From & To):	&
Telephone No.:
Mobile No.:

Previous Surname:
Forename(s):
Address:
Address:
Date (From & To):	&
Telephone No.:
Mobile No.:

Date of birth:
Sex:	Male Female
Town/Country of birth:
Nationality:
Marital Status:
Occupation of Spouse/Partner:
Spouse/Partner’s Employer:

Tick box for accommodation below:
House/Flat Owner:	Renting With Parent Lodging
If not born in UK, state the date & place of arrival in the UK.

National Insuance No.:
Date of Mariage:
No of Children:		Ages:
Religion:

Next of kin/ Person to be contacted in any emergency:

Name:
Address:

Relationship:
Work Tel.:
Home Tel.:

2. Personal References: Please give details of THREE people, other than family, who have known you well for at least 3 years who we may approach

Name:
Address:


Telephone No.:
Know for Year(s)

Name:
Address:


Telephone No.:
Know for Year(s)

Name:
Address:


Telephone No.:
Know for Year(s)

3. Driving Details

Do you have a current Driving License	Yes No
Please state type & Class: (i.e.) Provisional/ full/ Class:

Please give details of any current endorsements:

Do you have your own transport? ?	Yes No

4. Background Details:

HAVE YOU OR A RELATIVE APPEARED BEFORE A COURT, CHARGED WITH A CRIMINAL, CIVIL OR MILITARY OFFENCE AND HAVE BEEN CONVICTED, OR CAUTIONED BY THE POLICE FOR ANY OFFENCE?

Yes No

HAVE YOU ANY ALLEGED OFFENCES OUTSTANDING? (IF YES, GIVE DETAILS: )

Has a County Court Judgement ever been awarded against you or any member of your family?

Yes No

Please identify total financial commitment. (e.g.) Mortgage, Hire Purchase, etc…

Please state what you commitments are for below:

5. Education (Please state name & full address of schools, colleges & University attended:)

Date	Secondary School Attended	Exams Taken – Qualification gained

Dates	Colleges Attended	Exams Taken – Qualification gained

Dates	University Attended	Exams Taken – Qualification gained

Do you hold a valid certificate for FIRST AID?

Yes No

If YES State Expiry Date:

6. Service Record

Army Royal Navy R.A.F. Police Service Fire Service Merchant Navy

Regiment or Unit:
Rank Attained:

Regiment or Unit:	From To
Service No.

Physical Record

READ THIS SECTION CAREFULLY BEFORE YOU SIGN THE STATEMENT

If offered employment, it will be initially for a probationary period of three months.
During the probationary period your contract of employment will be terminable by you or by the company (Except in the case of gross misconduct), by not less than one week’s notice.
Continued employment will be subject to satisfactory vetting & medical..

DECLARATION

I CERTIFY THAT TO BE THE BEST OF MY KNOWLEDGE, THE INFORMATION I HAVE GIVEN IS COMPLETE AND CORRECT, & I UNDERSTAND THAT MISREPRESENTATION OF FACTS ARE GROUNDS FOR IMMEDIATE DISMISSAL, & I RENDERS ME LIABLE FOR PROSECUTION.

I AUTHORISE THE COMPANY TO APPROACH ANY GOVERNMENT AGENCIES, FORMER EMPLOYERS & PERSONAL REFERENCES TO VERIFY THE INFORMATION GIVEN, & WILL SUPPLY A STATUTORY DECLARATION IF REQUIRED.

Applicant Signature: Date:

7. Personal History

THIS SECURITY SCREENING PROCESS REQUIRES THAT WE ARE ABLE TO VERIFY YOUR PERIOD OF 20 YEARS OR TO THE DATE OF LEAVING SCHOOL. (Please Give Details of your personal history, identify in the space provided all periods of employment, registered or unregistered unemployment, military service and part time work). [BE SURE TO GIVE FULL & CORRECT ADDRESSES & DATES).

IF YOU HAVE EVER BEEN DISMISSED BY AN EMPLOYER, PLEASE GIVE FULL DETAILS IN THE RE ASON FOR LEAVING SECTION (Use a separate sheet if needed).

PLEASE DETAIL YOUR HISTORY STARTING FROM TODAY’S DATE:

From:

To:

PRESENT

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

From:

To:

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

From:

To:

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

From:

To:

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

From:

To:

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

From:

To:

Co. Name:
Address:

Telephone No.:

Position held:
Work No.:
Reporting to:
Last salary/wages paid weekly:

Reason of leaving:

8. Self Employment

In the case of periods of Self Employment, please give trade reference or name & address of someone who can confirm details.
(i.e.) Book keeper, Solicitor, Accountant, or other companies with whom you traded, etc…

Name:
Address:

From: To:

Name:
Address:

From: To:

Interviewers Notes: