GU-HRS-FM-0038 Rev 02

GTC UTILITY CONSTRUCTION LIMITED

Please return this form to: HR, Energy House, Woolpit Business Park, Woolpit, Bury St Edmunds, IP30 9UP or email it to

APPLICATION FOR EMPLOYMENT
Position For Which Applying:
Title: / Surname: / Nationality:
As detailed on passport
First Names:
Home Address:
Postcode:
Home Telephone No: / Mobile No: / email address:
Name and address of next of kin: / Relationship:
Daytime Tel:
Evening Tel:
TECHNICAL ASSESSMENT
Please complete this section in as much detail as possible.
Training and Experience (e.g. GNO1 or C&G 2339)
OCCUPATIONAL EXPERIENCE

Please give details of the last three positions held starting with your current or most recent position. Alternatively, please attach a current copy of your CV.

Employers Name
Employers Address
Date of Employment / From: / To:
Position Held
Main Duties & Responsibilities
Current Salary Package
Reason For Leaving
Employers Name
Employers Address
Date of Employment / From: / To:
Position Held
Main Duties & Responsibilities
Reason For Leaving
Employers Name
Employers Address
Date of Employment / From: / To:
Position Held
Main Duties & Responsibilities
Reason For Leaving
REFERENCES

Please give the names and addresses of two individuals to whom we may approach* for a reference. References should cover at least your last two years of employment.

Name: / Name
Position: / Position:
Company: / Company:
Address: / Address:
Tel. No.: / Tel. No.:
Email Address / Email Address

* No approach will be made to your current employer without your permission

DRIVING LICENCE DETAILS
Do you hold a current driving licence? / Yes / No
If Yes, how long have you held a full licence?
Do you have any endorsements or have you ever been disqualified from driving? / Yes / No
If Yes, please give details:
PRIVATE & CONFIDENTIAL
ADDITIONAL INFORMATION
Have you ever been dismissed by an employer? / Yes / No
Have you ever been convicted of a criminal offence? (Declaration subject to the Rehabilitation of Offenders Act. (Spent convictions do not have to be declared). / Yes / No
If you have answered Yes to any of the above questions, please give details below, including dates
Have you had any absence from work in the last 12 months other than agreed holiday? / Yes / No

If Yes, please give details except for actual sickness details.

Date / Reason for absence
(i.e. Sickness, Paternity Leave) / Number of days
absent from work / Certified by a GP?
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
How many days absence from work through illness have you had in the last 3 years?

Declaration:

The information given by me on this application for employment is, to the best of my knowledge, true. I understand that any falsification of information will result in my application being disregarded or if I have commenced employment, immediate dismissal.

Signed: / Name: / Date:

THIS DOCUMENT IS UNCONTROLLED IF PRINTED

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