JOB APPLICATION FORM
Please complete this form fully using black ink and return it to our business
address.
VACANCY DETAILS
Job Title Applied For: _____________________________________
Closing Date: ___________________________________________
1. PERSONAL INFORMATION
Field Details
Full Title: [ ] Mr [ ] Mrs [ ] Miss [ ] Ms [ ] Dr [ ] Other: _________
Surname / Family Name: __________________________________________________
Forenames / Given Names: __________________________________________________
Surname at Birth: (if
__________________________________________________
different)
Place of Birth: __________________________________________________
Current Nationality: __________________________________________________
Dual/Previous Nationalities: __________________________________________________
Contact Information
Permanent Address:
________________________________________________________________
______
Mailing Address: (if different)
__________________________________________________________
Email Address:
________________________________________________________________
__________
Home Telephone: ___________________________ * Mobile
Telephone: ___________________________
Legal & Residency Status
Are you a legal UK resident?
[ ] Yes [ ] No
Are you subject to immigration control?
[ ] Yes [ ] No
o If yes, please specify your visa type/status:
__________________________________________________
2. EDUCATION & QUALIFICATIONS
Please list all schools, colleges, or universities attended since the age of 14.
Name & Qualification Level
From To Subjects Date Awarded
Address of (e.g., GCSE, A-Level,
(MM/YY) (MM/YY) Taken / Expected
Institution Degree)
3. EMPLOYMENT HISTORY
Please provide details of all full-time and part-time work, including self-
employment, within the last 10 years. List your most recent employer first.
Current or Most Recent Employer
Employer Name & Address:
________________________________________________________________
__
Dates of Employment: From: _______________ To: _______________
Job Title: ____________________________________________
Key Duties & Responsibilities:
______________________________________________________________
Basic Salary: ___________________________ * Allowances /
Bonuses: ___________________________
Reason for Leaving:
________________________________________________________________
_______
Previous Employment
Please copy this layout if you need to add more roles.
Employer 1
Employer Name & Address:
________________________________________________________________
__
Dates of Employment: From: _______________ To: _______________
Job Title & Nature of Work:
________________________________________________________________
Reason for Leaving:
________________________________________________________________
_______
Employer 2
Employer Name & Address:
________________________________________________________________
__
Dates of Employment: From: _______________ To: _______________
Job Title & Nature of Work:
________________________________________________________________
Reason for Leaving:
________________________________________________________________
_______
Employer 3
Employer Name & Address:
________________________________________________________________
__
Dates of Employment: From: _______________ To: _______________
Job Title & Nature of Work:
________________________________________________________________
Reason for Leaving:
________________________________________________________________
_______
Accounted Time Periods
Please give details of any time gaps not covered above (including periods of
unemployment or study).
4. REFERENCES
Please provide two professional referees who can comment on your recent
employment. We will not contact your current employer without your explicit
permission.
Referee 1
Full Name:
________________________________________________________________
______
Professional Relationship:
________________________________________________________
Company/Organization:
___________________________________________________________
Address:
________________________________________________________________
________
Telephone: ___________________________ * Email/Fax:
___________________________
Referee 2
Full Name:
________________________________________________________________
______
Professional Relationship:
________________________________________________________
Company/Organization:
___________________________________________________________
Address:
________________________________________________________________
________
Telephone: ___________________________ * Email/Fax:
___________________________
5. INTERVIEWS & ACCESSIBILITY
Unavailable Dates: Please list any dates within 14 days of the closing
date when you are not available for an interview:
Interview Requirements: If you consider yourself to have a disability,
please indicate any special arrangements or adjustments you require to
comfortably attend an interview:
Vacancy Source: How did you hear about this job opening?
6. DECLARATION & PRIVACY AGREEMENT
Please read carefully before signing.
I declare that the details given on this application are, to the best of my
knowledge, true and complete. I understand that my application may be rejected
or, if I am already appointed, I may be dismissed if I withhold relevant details or
give false information.
I give permission for all or part of this application and references to be
held on both computerized and manual data records, which I may request access
to under data protection regulations.
Signed: _____________________________________________ Date:
________________________
Print Name:
________________________________________________________________
___________
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EQUAL OPPORTUNITIES & ETHNIC MONITORING
[YOUR BUSINESS NAME] has a strict policy of equal opportunity. Everyone
who is eligible to join our organization will receive equal treatment when applying
for jobs, regardless of sex, marital status, race, colour, ethnic origin, or national
origin.
To ensure our diversity policy is working effectively, we request that you
complete this brief questionnaire. Your answers will be treated with the strictest
confidentiality and will be separated from your application form before the
selection process begins. It will not affect your job application in any way. Thank
you for your cooperation.
Please review the categories below and tick the box you most closely identify
with:
[ ] 1. White
[ ] Any White background (Specify if you wish):
______________________
[ ] 2. Asian / Asian British
[ ] Bangladeshi
[ ] Indian
[ ] Pakistani
[ ] Any other Asian background (Specify if you wish):
______________________
[ ] 3. Black / African / Caribbean / Black British
[ ] African
[ ] Caribbean
[ ] Any other Black background (Specify if you wish):
______________________
[ ] 4. Chinese
[ ] Any Chinese background (Specify if you wish):
______________________
[ ] 5. Mixed / Multiple Ethnic Groups
[ ] Asian and White
[ ] Black African and White
[ ] Black Caribbean and White
[ ] Any other mixed background (Specify if you wish):
______________________
[ ] 6. Other Ethnic Group
[ ] Any other ethnic background (Specify if you wish):
______________________