HB Commercial Ltd - employment application

EMPLOYMENT OPPORTUNITY

What position are you applying for?

PERSONAL DETAILS

Title

Surname

First name(s)

Your email

Date of birth

Do you require authorised documentation to work in the UK?

Address

Postcode

Home telephone

Mobile telephone

UK work documentation

Have you ever been convicted of any criminal offences which are not yet "spent" under the Rehabilitation Act 1974?

Criminal offence details

Do you have a full UK driving licence?

Do you have your own transport?

Do you have any driving licence endorsements

Driving licence endorsement details

Do you hold any driving licences or permits other than a motorcar licence?

Other licence details

HEALTH

How many days have you been absent from work due to illness in the last two years?

Please include date(s) of illness / conditions, frequency, duration, what treatment was given and by whom (e.g. hospital / GP), whether you are still undergoing treatment and length of absence from work / school (if appropriate).

Are you currently taking any form of medication?

Medication details

Under the terms of the Act a ‘disability’ is defined as a "physical or mental impairment, which has a substantial and long-term effect on a person’s ability to carry out normal day-to-day activities". Do you have a disability?

Do you require us to make special arrangements to enable you to attend an interview?

EDUCATION

SECONDARY EDUCATION

Secondary schools attended

Subjects

Qualifications gained

FURTHER EDUCATION

Further education facilities

Subjects

Qualifications gained

CURRENT EMPLOYMENT

Name and full address of current employer

Position held

Nature of business

Total annual earnings (including expenses/overtime)

Other benefits

Responsibilities

Reason(s) for wishing to leave

EMPLOYMENT HISTORY

PREVIOUS EMPLOYMENT 1

Name and full address of previous employer

Final salary and benefits in this employment

Date employment commenced

Date employment ended

Appointment, job title, reporting to, duties and achievements

Reason for leaving this employment

PREVIOUS EMPLOYMENT 2

Name and full address of previous employer

Final salary and benefits in this employment

Date employment commenced

Date employment ended

Appointment, job title, reporting to, duties and achievements

Reason for leaving this employment

PREVIOUS EMPLOYMENT 3

Name and full address of previous employer

Final salary and benefits in this employment

Date employment commenced

Date employment ended

Appointment, job title, reporting to, duties and achievements

Reason for leaving this employment

PREVIOUS EMPLOYMENT 4

Name and full address of previous employer

Final salary and benefits in this employment

Date employment commenced

Date employment ended

Appointment, job title, reporting to, duties and achievements

Reason for leaving this employment

REFERENCES

Please give names and addresses of two referees

REFEREE 1 - CURRENT / MOST RECENT EMPLOYER

Name and full address

Postcode

Telephone

Occupation

REFEREE 2 - PREVIOUS EMPLOYER

Name and full address

Postcode

Telephone

Occupation

DECLARATION

I declare that the information contained in the form is true and complete. I understand that any false or misleading information given by me in this application form, or during an interview or medical examination, may result in my dismissal without notice, if I am appointed. I consent to the information I have given this application form and in all other enclosed documentation being held, used and updated under the security safeguards of the Data Protection Act 1998.

I agree

I understand that giving false information or omitting relevant information could disqualify my application or if appointed, could lead to my dismissal. The information I have provided is accurate and I have not withheld any details. I will notify you immediately if any of my answers change on my completed form. I consent to this data being held by an Occupational Health Unit on a computer or manual filing system, in accordance with the confidentiality requirements of the Data Protection Act 1998.

I agree

FORM SUBMISSION

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