The Information You Supply on This Form Will Be Treated in Confidence

IXION APPLICATION FORM

The information you supply on this form will be treated in confidence.

Please complete this form fully using. Applications received after the closing date will not normally be considered.

Ixion is an Equal Opportunities Employer. All appointments will be made in line with our Equal Opportunities Policy.

Job applied for:
Last name / First name(s):
Address:
Postcode: / Home telephone number:
Daytime number:
Mobile number:
Email address:

Working in the UK

Are you free to remain and take up employment in the UK
with no current immigration restrictions? Yes No

If ‘Yes’ and there are conditions attached, for example start or finish dates, please specify in the box below [Please note that if you are offered employment, you will be required to provide evidence of this]:

If ‘No’, what type of work permit do you require? Please state in the box below:

Employment History

If this is your first job after leaving school or college, you may like to give details of any holiday, weekend or evening job or work experience placements.

Please also refer to any gaps in your employment history in the separate box, and add a continuation sheet if necessary.

CURRENT OR LAST EMPLOYER
Name of employer:
Address:
Postcode:
Telephone number:
Position(s):
Brief description of duties & key achievements:
Date(s) employed:
Reason for leaving: / Current/last salary:
Details of benefits & bonuses:
PREVIOUS EMPLOYER
Name of employer:
Address:
Postcode:
Telephone number:
Position(s):
Brief description of duties & key achievements:
Date(s) employed:
Reason for leaving:
PREVIOUS EMPLOYER
Name of employer:
Address:
Postcode:
Telephone number:
Position(s):
Brief description of duties & key achievements:
Date(s) employed:
Reason for leaving:
PREVIOUS EMPLOYER
Name of employer:
Address:
Postcode:
Telephone number:
Position(s):
Brief description of duties & key achievements:
Date(s) employed:
Reason for leaving:

Gaps in Employment

Reason / Dates (Month – Year)
From / To

Education & Professional Qualifications

Dates / Name of school/higher education college/university/place of study etc / Qualifications taken & grades obtained

Please continue on separate sheet if necessary.

Membership of professional bodies

Date / Details

Personal Development (including any courses, e.g. IT skills, or in-house training you consider relevant to this application, with level of proficiency where applicable)

Provider / Type of development/proficiency
Languages / State level spoken: Native speaker, fluent, business proficient or other

Other Activities (for example, community work or voluntary experience that you consider relevant to this application)

Are you related or have a relationship with any current employee of Ixion

Yes No

If ‘Yes’, please state who and relationship below:

Other Work Commitments

Do you have any other work commitments, either paid or unpaid, which you would wish to continue with if offered employment by Ixion.

Yes No

If successful you will require prior permission from Ixion, be employed or otherwise engaged in any other business, trade or profession either directly or indirectly in any capacity whatsoever.

Driving Licence

You only need to fill in this section if a driving licence is an essential requirement on the Job Description.

Do you hold FULL current driving licence? Yes No

Do you own/have use of a car for work? Yes No

Supporting Statement

Please state why you have applied for this post. Indicate past achievements, qualifications, knowledge, experience and personal qualities that match the criteria in the Job Description. What contribution would you expect to make in the post?

References

Reference Consent Declaration
I give consent for Ixion to take up references with previous and/or current employers listed below.
Name (Print):
Signature:
Date:

Pleases give names of all employers (or tutor/college in the case of a student), covering your recent employment history up to a minimum of the past 3 years. If these employers know you by a different name from the one you have given at the beginning of this form, please give that name below. If you have been unemployed during this period, please also include these dates.

References may be taken up before an offer of employment is made, and in certain circumstances, a reference may be requested from any of your previous employers. Please start with the details of your last/current employer.

Name of Employer:
Dates when employed (month/year): From: To:
Address:
Telephone number:
Please place an ‘X’ in the box if you do not wish us to contact this employer before you come
for interview.
Name of Employer:
Dates when employed (month/year): From: To:
Address:
Telephone number:
Please place an ‘X’ in the box if you do not wish us to contact this employer before you come
for interview.
Name of Employer:
Dates when employed (month/year): From: To:
Address:
Telephone number:

Please place an ‘X’ in the box if you do not wish us to contact this employer before you come
for interview.

Please copy/print this sheet, if you need additional space.

DECLARATION BY APPLICANT

I declare that the information on this form is accurate, and I accept that should any statement made by me in connection with this application be found to be false, the application shall be void and as a result any contract arising may be terminated by the Company at any time.
Ixion is registered under the Data Protection Act 1998 to hold information about employees. The information provided on this form will be used as part of our selection process. It will be retained for a period after the selection process has been completed. By signing below, you consent to the information on this form being used for these purposes.
Signature: * Date:
*A digital signature will be as binding as your actual signature and indicates your agreement with the following statements:
By typing my name in the following box I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.

THE NEXT STEP

Once you have completed all sections of the application form please submit your application along with separate confidential section and equality and diversity form as indicated or send it to the Head office address indicated in the vacancy advert.

Your application will be processed and you will be advised of the outcome as soon as possible.

Ixion Application Form V1 Version A March 2013 Page 9 of 9