Please complete the form below. Once complete save and send the attachment to Thank you

1.  What position are you applying for? Work experience

1.1  When would you be available for work experience:______

1.2  Do you have the right to work in the UK? Yes c No c (please tick as applicable)

2.  Your details

Title / Surname / Forename(s)
Address
Postcode
Home phone number / Mobile number
Email

3.  Secondary Education

School(s) you went to from age 11 / Examinations (subject and results)

4.  University Education

University you went to / Date(s) / Degree Course & Classification
From / To

5.  Occupational Qualification eg, GDL

Name of College/
University/Other institute / Date(s) / Results
From / To

6.  Skills and Experience

Please outline your key skills and experience gained through paid employment, work experience or other activities or interests which you feel are relevant to your application:

7.  Previous Employment

Please include details of your most recent employment and use the space below to give details of other periods of employment – working backward from the most recent
7.1  Name of present employer
Address
Starting date / Leaving date
Job title
Reason for leaving
7.2 Previous employer
Address
Starting date / Leaving date
Job title
Reason for leaving
7.3 Previous employer
Address
Starting date / Leaving date
Job title
Reason for leaving

8.  Health/Disability

Please give details below if you have a disability or suffer from ill health about which we should know and which may affect your ability to perform the job for which you are applying:
How might we overcome any limitations?
Are you prepared to undergo a medical examination, if required?
Yes c No c (please tick as applicable)

9.  Interests/Hobbies

Please give details of pastimes, sports, offices held in social/sports clubs, etc or other activities (eg, voluntary work):

10.  If you wish to do so, please give details of next of kin or person who can be contacted in an emergency:

Name
Address
Relationship / Phone number

11.  Recruitment policy

It is the Company’s policy to employ the best qualified personnel and provide equal opportunities for the advancement of employees including promotion and training and not to discriminate against any person because of race, colour, ethnic or national origin, sex or marital status, sexual orientation, religion or belief, union membership or non-membership or disability.

12.  Declaration

If this application is successful, I agree to abide by the Company’s Rules and Regulations and Conditions of Employment (a copy is available if required).
I understand that if an offer is made, it is subject to a 13 week trial period which may be extended if required.
Declaration: I confirm that the information given on this form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection, or if employed, dismissal.
I give permission to contact the employers listed in section 7 above concerning any previous employment. If there is a particular employer you do not wish us to contact, please indicate which one(s).
Signature / Date

www.hillyermckeown.co.uk Chester | Liverpool | Wirral | North Wales