Staff Vacancy Application Form

APPLICATION FOR THE POST OF:
A. PERSONAL DETAILS
1. MR MRS MISS
2. Surname:
3. Any previous surname:
4. Forenames:
5. Address inc postcode:
6. Telephone:
7. Email address:
8. Date of birth:
9. National Insurance No.
10. Nationality:
11. Ethnic origin (please tick as appropriate)African Asian Caribbean UK European Irish Other European Other
12. Religion:
13. Are you registered disabled?Yes No
14. Are you in good health?Yes No
15. If you answered YES to questions 13 or 14 above then please give details here;
16. Available to take up employment with effect from (date):
17. Prepared to work (please select):Full-time Part-time
18. Are you prepared to work night shift?Yes No Not applicable
Please note: This company is an equal opportunities employer. The aim of this policy is to ensure that no job applicant or employee receives less favourable treatment on the grounds of sex; handicap; marital status; creed; colour; race or ethnic origin or is disadvantaged by conditions or requirements which cannot be shown to be justifiable.
B. DRIVING
19. Do you own a car?Yes No
20. Do you hold a current driving licence?Yes No
21. Please give details of any current endorsements:
C. EDUCATION
22. Secondary school(s) attended - please include dates:
23. Further education - please include dates:
24. Qualifications gained - please include dates of awards:
25. QUALIFICATIONS OBTAINED (e.g. NVQ‚ Food & Hygiene Certificate‚ First Aid Certificate‚ etc.)
D. EMPLOYMENT RECORD
26. PRESENT OR MOST RECENT EMPLOYER:
Nature of business:
Address:
Starting date:
Leaving date:
Current or last salary or wage
Your main duties in this employment:
27. PREVIOUS EMPLOYER:
Nature of business:
PLEASE BEAR WITH US - WE ARE IN THE PROCESS OF BUILDING THIS SITE AND THIS FORM IS NOT YET COMPLETE‚ BUT YOU CAN STILL SUBMIT IT
THANK YOU FOR YOUR INTEREST
Verification code43153
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Contact Details

Address :
Alfreton Road
Coxbench
Derby
DE21 5BB

Tel : 01332 880200
Fax : 01332 881199
Email : Click here


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