ROSE Recruitment APPLICATION FORM

Name:
Address:
Email : / Nationality:
VISA Type:
Expiry Date:
( (home): / ( (work/mobile): / Home Tube or Station:
Emergency Contact:
Relationship to contact: / ( (work/mobile):
( (home): / Time it takes to Central London:
Languages:
Media experience / Experience includes (TV, radio, print, digital, POS, CRM etc) / When/Where used last? / How many years experience?
ATL
TTL
BTL
Computers/Packages: (please circle) Beginner Intermediate Advanced
(Please tick)
Mac YES/NO
PC YES/NO
Lotus Notes YES/NO
Outlook YES/NO
Word YES/NO
Excel YES/NO
PowerPoint YES/NO
Sap YES/NO
Please note other packages that are not listed:
Looking for Temp/Contract/Perm/All
Min Temp rate: £ p/h Salary requested: £ Min salary: £ Current Salary: £
Smoker: YES/NO / Smoker at Work: YES/NO
Do you have any medical conditions/disabilities that affects your work, that we should be aware of?
Type of company/position preferred:

EMPLOYMENT HISTORY - CURRENT OR MOST RECENT:

Dates / Company / Type of company / Position / Salary / Reason for leaving

How did you hear about us? ______

Notice period for current position? ______

Do you have any upcoming holidays planned? ______

(please complete if looking for temp work)
NI Number: / Ac/no:
Sort: / BANK:
Has any judgement ever been entered against you in civil proceedings (Including County Court Judgements) or in arbitration or are proceedings pending in which such a judgement or award against you is a possibility, in any jurisdiction?
If so, please give details.
Do you have any convictions for criminal offences (excluding minor traffic offences), which have not expired( whether or not in the UK) or are currently engaged in or subject to, any criminal proceedings? If so, please give details.
I certify that the above statements are true. I understand that Rose Recruitment will keep my personal information private and not disclose to any other parties.
Date: Signature:

Consultant's notes:

Have you taken a photocopy of their ID?

______

______

______

______

______

C:\My Documents\Rose Associates\application form - A4 version.doc