Job Application Form

Position Applied for:

Present Job Title:		Date Started:
Employer:
Salary & Benefits:
Major duties and responsibilities:

Previous Posts (please start with the most recent)

Job Title	Employer	Dates (From – To)	Salary

Education & Training

Secondary Education	Qualifications/Grades

Further / Higher Education	Qualifications / Grades

Other relevant training, professional qualifications or work related skills (for example languages, shorthand etc.)

Are you undertaking any course of study at present?
(If so, please give details)

Do you have membership of any professional bodies?
(If so, please give details, including any offices held)

It is the Company’s policy to verify the qualifications of all successful job applicants and you may be asked at a later stage in the recruitment process for your consent to checks being carried out.

Supporting Information

Please give any details you feel are relevant in support of your application, including why you are interested in this post.

Other Details

What is the notice required in your present post?
Is your present post your sole regular employment?		Yes/No (check for Yes)
Are you a British subject or a national of any EU country?		Yes/No (check for Yes)
If “No” do you have the right to work in the UK and hold a current work permit?		Yes/No (check for Yes)
If so please state the expiry date of your right to work in the UK and/or your work permit.
Do you have a full driving licence?		Yes/No (check for Yes)
Do you have any current endorsements?		Yes/No (check for Yes)
Do you have use of a car?		Yes/No (check for Yes)
Where did you see the advertisement for the post?
What is your National Insurance Number?

Disabilities

Do you have a disability?		Yes/No (check for Yes)
If “Yes” please give brief details of the effects of your disability on your day to day activities, and any other information that you feel would help us to accommodate your needs and thus meet our obligations under the Disability Discrimination Act 1995

Convictions

Have you ever been convicted of a criminal offence? If so please give details of any unspent convictions. As this post is one covered by the Rehabilitation of Offenders Act 1974 (exceptions) Order 1975 both spent and unspent convictions must be declared:

References

Please give the details of two referees, stating how long you have known them. (One should be your current or most recent employer). References for short listed candidates will be taken up before interview unless you request otherwise.

Referee 1		Referee 2
Name:		Name:
Address:		Address:
Telephone Number:		Telephone Number:
Occupation:		Occupation:
Time Known:		Time Known:
May References be taken up before interview?	Yes/No (check for Yes)	May References be taken up before interview?	Yes/No (check for Yes)

Data Protection

Information from this application may be processed for purposes registered by the Employer under the Data Protection Act 1998. Individuals have, on written request the right of access to personal data held about them. I hereby give my consent to Brocket Hall International Ltd processing the data supplied in this application form for the purpose of recruitment and selection.
Declaration:
I declare that the information given in this application is, to the best of my knowledge, complete and correct. Note: Any false, incomplete or misleading statements may lead to dismissal

Personal Details

Title (Mr, Mrs, Miss, Ms, Other):		Forename(s):
Surname:		Daytime telephone number:
Current Address:		Evening telephone number:
		Mobile number:
		E-mail address: