Job Application form

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1 Job Application form Post Applied for: Closing Date: form Job Reference: form Please complete this form in black ink. Applications received after the closing date will not normally be considered. THE INFORMATION YOU SUPPLY ON THIS FORM WILL BE TREATED IN CONFIDENCE Section 1 Last Name: Personal Details First Name: Postcode: Home Telephone No: National Insurance No: Daytime Telephone No: Mobile Telephone No: address: How would you prefer us to contact you in business hours? Are you free to remain and take up employment in the UK with no current immigration restrictions? Yes No Driving License- if relevant to post applied for. Yes No Do you hold a full, clean driving license valid in the UK? If you are successful you will be required to provide relevant evidence of the above details prior to your appointment.

2 Section 2 Present Employment Present Employment (If not currently employed go to Section 3) Name of Employer: Postcode: Post Title: Date of Appointment: Salary: Department / Section: Brief description of duties: Continue on a separate sheet if necessary Period of Notice: Reason for Leaving (If no longer employed) Last day of service (If no longer employed)

3 Section 3 Previous Employments Previous Employment (most recent employer first). Please cover the last 10 years minimum and state nature of business. Continue on a seperate sheet if necessary. Name of Employer: Dates of Employment; From; To; Postcode: Position Held: Summary of duties: Reason for Leaving: Name of Employer: Postcode: Dates of Employment; From; To; Position Held: Summary of duties: Reason for Leaving:

4 Section 4 Education Qualifications obtained from schools, colleges and universities. Please list most recent qualification first: College or University Dates (from & to) Course Qualifications/ Grades School/ College Dates (from & to) Course Qualifications/ Grades School/ College Dates (from & to) Course Qualifications/ Grades

5 Professional, Technical or Management Qualification Please give details: Professional/Technical/ Management Qualifications Course & Dates Achieved Membership of any Professional/Technical Associations- Please state level of membership: Continue on a seperate sheet if necessary Section 5 Training & Development Please give details of any training and development courses or non-qualifications courses which support your application. Include any on the job training/ Continuing Professional Development as well as formal courses. Title of training Programme or course & Date Duration of Course Continue on a seperate sheet if necessary

6 Section 6 Personal Statement Abilities, skills, knowledge and experience. Please use this section to explain in detail how you meet the requirements of the Person Specification. If you are or have been involved in voluntary/unpaid activities, please also include this information. Attach and label any additional sheets sent to us. Section 7 References Please supply us the details of two employment (or college) referee s. These will only be contacted should any job offer be made and accepted. Reference 1 Reference 2 Name: Position (Job title): Work Relationship: Name: Position (Job title): Work Relationship:

7 Organisation: Organisation: Telephone No: Telephone No: Section 8 Declaration The information in this form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details. I agree to the above declaration Signature Name Date NB. Candidate s selected for interview will normally be notified within two weeks of the closing date. Unfortunately applicants who do not hear from MV Kelly Ltd must conclude that their application has been unsuccessful on this occasion. Thank you for your interest in this post. M V Kelly Ltd treats any personal information that you provide to us or we obtain from you, in accordance with the requirements of the Data Protection Act If you are returning this form by , you will be asked to sign your application at interview. RETURNING THIS FORM By Post : By Human Resources M V Kelly Ltd 25 Enquires: Telephone:

8 Recruitment Monitoring Form We recognise the benefits of having a diverse workforce and therefore welcome applications form all sections of the community. In addition to this, under the provisions of the, we are required to demonstrate that out recruitment is fair and that we do not discriminate against or placing anyone at a disadvantage because of their age, disability, gender reassignment status, marriage or civil partnership status, pregnancy or maternity, race, religion or belief, sex or sexual orientation. Therefore a series of questions need to be raised in order to ascertain who is applying for each position and to ensure that no one is being unfairly discriminated against or disadvantaged. This sheet will be separated from your application form upon receipt and does not form part of the selection process. It will be retained by the Human Resources department purely for monitoring purposes. Application for the post of: The protects people against discrimination on the grounds of their age and sex. Please state your date of Birth: Please indicate your gender : Male Female I do not wish to disclose this The protects people who are married or in civil partnership. Please indicate the option that best describes your marital status Married Single Civil Partnership Divorced Widowed I do not wish to disclose this The protects people against discrimination on the grounds of their race which includes colour, nationality, ethnic or national origin. Please indicate your ethnic origin Asian or Asian Black Mixed Other Ethnic Group Bangladeshi White & Asian Chinese Indian White & Black African Any other ethnic background Pakistani White & Black Caribbean

9 Any other Asian Background Any other mixed background Asian or Asian Black White African Caribbean Any other black background I do not wish to disclose this. British Irish Any other white background The protects bisexual, gay, heterosexual and lesbian people form discrimination on the grounds of their sexual orientation. Please indicate the option which best describes your sexual orientation Lesbian Gay Bisexual Heterosexual I do not wish to disclose this information The protects people against discrimination on the grounds of their religion or belief, including a lack of any belief. Please indicate your religion or belief Atheism Islam Other Buddhism Jainism I do not wish to disclose Christianity Judaism Hinduism Sikhism The protects disabled people- Including those with long term health conditions, learning disabilities and so called hidden disabilities such as dyslexia. If you tell us that you have a disability we can make reasonable adjustments to ensure that any selections processes- including interview- are fair and equitable. Do you consider yourself to have a disability? Do you consider yourself to have a disability? Yes No I do not wish to disclose this information Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark other. Physical Impairment Sensory Impairment Mental Health Condition Learning Disability/Difficulty Long-standing Illness Other If you have a disability, do you wish to be considered under the guaranteed interview scheme if you meet the minimum criteria as specified in the person specification?

10 Yes No

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