Application for Employment s100

APPLICATION FOR EMPLOYMENT

POSITION APPLIED FOR:
APPLIEDJob title:

Where did you see this vacancy advertised?
Please tick which one and give details as applicable / Website:
Agency (please detail):
Referral (please detail):
University (please detail)
Other (please detail):
1) APPLICANT’S DETAILS:

Title: / Surname: / First name:

PPLIED

Current address (inc postcode): / Telephone nos (please include full STD code):
Home
Mobile
e-mail address

APPLIED

Do you hold a current driving licence? / Yes/No
PLIED FOR: APPLIED Do you have the legal right to work in the UK? / Yes/No
If yes and there are conditions attached,
e.g. start and finish, please specify
If yes and you have a visa please specify what type
How much notice do you need to give to your current employer?
Please indicate your salary expectation
Have you ever been convicted of a criminal offence, including driving disqualifications, (other than spent convictions under the terms of the Rehabilitation of Offenders Act 1974)? / Yes/No (if yes please give date(s) of conviction/cautions(s) and brief details)
Do you have any criminal proceedings pending against you? / Yes/No (if yes please provide further information)
Do you have any County Court Judgements registered against you? / Yes/No (if yes please give brief details of who, date(s),amount(s)
Do you have any pre-booked holidays?
2) EMPLOYMENT RECORD:

Please start with your most recent employment. Briefly describe the main duties and responsibilities of your post. If you wish to expand on specific areas of responsibility, please do so in Section 5: Experience /skills.

1. Current/most recent employer/organisation
Name:
Address:
Position(s) held:
Dates employed
Brief description of duties:
Reason for leaving/changing:
Salary (inc any benefits):
Notice required (if still employed):
2. Employer/organisation
Name:
Address:
Position(s) held:
Dates employed
Brief description of duties:
Reason for leaving/changing:
Salary (inc any benefits):
3. Employer/organisation
Name:
Address:
Position(s) held:
Dates employed
Brief description of duties:
Reason for leaving/changing:
Salary (inc any benefits):
4. Employer/organisation
Name:
Address:
Position(s) held:
Dates employed
Brief description of duties:
Reason for leaving/changing:
Salary (inc any benefits):
Gaps in employment :
Please tell us about any gaps in your employment e.g. voluntary work, travel, career break, unemployment.
Dates: / From: To:
Details:
3) EDUCATION:

Please tell us about your education and any qualifications which you feel are relevant to the post. Include relevant courses which you are currently undertaking. Please start with the most recent.

University Details:
Name:
Course Studied:
Qualification (if known):
Dates attended: / From: To:
Completed a placement? / Yes/No (if yes, please complete the following questions)
Placement Details (if applicable)
Name:
Address:
Position(s) held:
Dates employed
Brief description of duties:
Details of A-Levels:
Name of school/college:
Dates attended: / From: To:
A-Level Subjects / Results
Details of GCSEs:
Name of school/college:
Dates attended: / From: To:
GCSE Subjects / Results
4) PERSONAL DEVELOPMENT/TRAINING:

Please list any training or courses which you have undertaken or professional body membership which you hold.

Training Course / Date from / Date to
5) EXPERIENCE/SKILLS:

This section is for you to give specific information in support of your application. It is your opportunity to tell us about yourself & how you best fit the requirements of the job. You should demonstrate to us that you meet all the essential criteria on the Job Description & if applicable, the desirable criteria.

6) ABOUT YOU:

Please tell us about your hobbies and interest and any other outside activities/achievements.

7) REFERENCES:

Please provide details of two referees (not relatives or friends) who will provide an employer’s reference to cover the last five years of employment. One of these referees must be your current or most recent employer. If you do not have a current or recent employer, please provide details of your lecturer/course tutor/unpaid work employer etc.

First Reference:

Name:
Position:
Address:
Tel:
Email Address:
Can we contact this referee before the interview? / Yes No

A Second Reference:

Name:
Position:
Address:
Tel:
Email Address:
Can we contact this referee before the interview? / Yes No
8) REQUEST FOR REASONABLE ADJUSTMENTS TO THE SELECTION PROCESS:

We welcome applications from individuals with disabilities and are committed to ensuring fair treatment throughout the recruitment process. We will make adjustments to enable applicants to compete to the best of their ability wherever it is reasonable to do so, and, if successful, to assist them during their employment. We encourage applicants to declare their disabilities in order that any special arrangements particularly for the selection process can be accommodated. Applicants or employees can declare a disability at any time.

If you wish to do so, please enter any reasonable adjustments connected with a disability which you require to be made to the selection process in the box below: If, however, you would prefer to discuss any special arrangements with us, please contact or the organisation representing your application.

9) APPLICATION DECLARATION & DATA CONSENT:

The information supplied in this application form will be used to process your application. It will not be passed to third parties or used for other purposes.

Fraud prevention databases have been established for the purpose of allowing employers to share data on their employment fraud cases.
All applicants applying for employment with Synectics Solutions will have their details checked against fraud prevention databases. Should our investigations identify fraud or the commission of any other criminal offences by you when applying for, or during the course of your employment with us, we will record the details of this on the relevant fraud prevention databases. This information may be accessed from the UK and other countries and used by law enforcement agencies and by us and other organisations to prevent fraud. Please contact the HR Department on 01782 664000 if you want to receive details of the relevant fraud prevention databases through which we share information.
If you are successfully offered a position, we will keep your application form.
If you are unsuccessful we will keep your details on file for 12 months for potential future opportunities.

Security procedures are in place for protecting your data in accordance with the principles of the Data Protection Act 1998. Your details may be stored electronically in a password-protected system and/or paper copies in secure storage.
Please read the statements below and then sign and date to confirm your acceptance of them:

· I have read the above, and I understand and accept how Synectics Solutions will use and store my personal data.

· I confirm that the information I have given in this application form and any supporting documents is complete.

· I understand that failure to disclose any relevant information or the provision of false information my lead to dismissal/withdrawal of any offer of employment made to me.

· I understand that Synectics Solutions may check all or any of the information provided as part of my application or given references.

· I understand that an appointment, if offered, will be subject to the receipt of references, and the outcome of any relevant pre-employment checks/which Synectics Solutions regards as satisfactory.

· I understand that if an offer of employment is made I will be subject to a County Court Judgements, Criminal Records Bureau Check and other fraud and other criminal background checks as set out in Section 9 above.

· I understand I will be required to provide documentary proof at interview of photographic ID, current Visa (if applicable) and original certificates of any qualifications listed by myself.

Signed: Date:

Thank you for completing the form. Please e-mail to: or send to: Recruitment Department; Synectics House; The Hollies; The Brampton; Newcastle-under-Lyme; ST5 0QY

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Classification: Confidential once completed. Owner: Natascha Barnacle V.4.4, 28/04/2016