Employment Application Form

We are registered with the Data Protection Registrar under entry Z1748242


Surname ______Forenames______

Contact Telephone Numbers ______

(Place your preferred contact number first)

Email Address ______National Insurance No _____ / _____ / _____ / ______


Hours of Work Preferred: ______

Dates not available over the next 2 months:______

(Reference Assessment/Interview)


Where did you hear about this position? ______Have you applied before? Y/N

Have you previously been employed by Gerber Juice Company Ltd/GerberEmig Group or Gerber Foods Soft Drinks Ltd or worked for our company through an external agency/contractor? Y/N

If yes, please provide details below:

Job Title ______Reason for Leaving ______


Date of Leaving ______Agency/Contractor name ______

If you are currently working for Gerber please note it is your responsibility to ensure yourLine Manager is aware of your approach for this post. Please obtain their signature before forwarding the application to Liz McCrorie.

Signature______Printed Name______

What proof of Identity do you hold please circle: Passport / ID Card / Birth Certificate / NI Number

Do you have entitlement to work in the UK?Y / N

Do you have any convictions, which are not “spent” under the Rehabilitation of Offenders Act 1974?Y/N

If yes, please detail ______


Are you intending to have any other paid employment if you join Gerber Juice Company Ltd? Y / N

EDUCATION & QUALIFICATIONS – Please enclose photocopies of your certificates with this application (if not obtained through Gerber)

Warehouse Positions:CB LicenceY/Nexpiry date ______

Reach TruckY/Nexpiry date ______

Very Narrow Aisle (VNA)Y/Nexpiry date ______

Basic Health SafetyY/N

Basic Food HygieneY/N

Production Positions:Quality Assurance ExperienceY/N

Continuous Improvement ExperienceY/N

Engineering Qualification/sY/N

Basic Health SafetyY/N

Basic Food HygieneY/N

Office Positions:Basic Health SafetyY/N

Basic Food HygieneY/N

Computer SkillsY/N

Work History -Please list your current and all previous employers leaving no gaps, giving most recent information first (continue on a separate sheet if necessary)

SUPPORTING STATEMENT – Please outline the skills, experience and knowledge you have gained through your work history, education or leisure activities which are relevant to your application.

References – Please give details of 2 employment references, one of which should be your current or most recent employer. We must ensure at least the last two years are covered, please continue on to a separate page if necessary. If you have not worked before, provide 2 character references who are not family members. We will not approach your referees until an offer of employment has been made.


Name: ______Name: ______

Job Title: ______Job Title: ______

Address: ______Address: ______


Tel No:______Tel No:______

I confirm that the information given on this application form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection or, if employed, dismissal.

Signed: ______Date: ______

Print Name: ______

Thank you for taking the time to complete this form, if you do not fully complete this form we may not consider your application any further. Please note candidates may be required to undertake assessments and interviews as part of the selection process, please let us know of any special requirements.

Return this application to:

Liz McCrorie

Gerber Juice Company Ltd

Mallard Court

Express Park


SomersetTA6 4RN

Please make sure you have enclosed the following with your completed application (place a tick in the circle):

I have attached a covering letter/separate sheet.

I have enclosed photocopies of certificates that are relevant to the job application. (if not obtained through Gerber)

Office Use Only:

Comments on Application

Tel: 01278 441657 Fax: 01278 441691 Web Site: Email:

All information collated on this form will be kept in the strictest confidence.