Position applied for …………………….…………………………………..….… Date ……….…..….

Full-time  Part-time  Temporary 

How did you learn of this position? ……………………….…………………..………………………..

Title: / Mr / Mrs / Ms / Miss / Tel: Home No ...………………………..
Surname / Mobile No ………………………….
Forenames / Daytime No ………………………….
Address .………………………………………………………………………………………………..
…………………………..…………………………. Postcode ………………………………..
e-mail address:
Do you have the right to take up employment in the UK, and if necessary, a Work Permit? / Yes  / No 
Dates you are not available for interview:
If you have a disability, please give details of any special arrangements you would require to attend interview:

EDUCATION & QUALIFICATIONS

From GSCE to Degree Level in chronological order (if applicable) / NVQs, HNC, HND, Technical qualifications, etc
Do you have any other training, qualifications, skills relevant to this post? If so, please detail:
Membership of a professional organisation?
If yes, give details:

EMPLOYMENT HISTORY

1. Name, address and type of business of present (or most recent) employer
Date from
Date to
Reason for leaving: / Leaving salary / £
Duties and responsibilities:
2. Name, address and type of business of employer / Date from
Date to
Reason for leaving / Leaving salary / £
Duties and responsibilities:
3. Name, address and type of business of employer / Date from
Date to
Reason for leaving / Leaving salary / £
Duties and responsibilities:

OTHER INFORMATION

Any other previous employment history or achievements you feel may be relevant to this role.
Do you hold a full driving licence?
If you have any current endorsements, please give details. / Yes  / No 
How much notice do you have to give your present
employer? / 1 week / 1 month
Other, please detail

HOBBIES/INTERESTS

Detail your leisure activities/interests/hobbies.
REFERENCES
Please give details of two people who can be contacted, with your consent, for references (not a relative or a friend). One must be your present or most recent employer.
NB: Current employer will not be contacted until an offer of employment has been made and
accepted.
Name: …………………………………………… / Name: ……………………………………………
Job Title: ………………………………………… / Job Title: …………………………………………
Company: ………………………………………. / Company: ……………………………………….
Address: ………………………………………… / Address: ..……………………………………….
……………………………………………………. / …………………………………………………….
……………………………………………………. / …………………………………………………….
Tel. No: …………………………………………. / Tel. No: ………………………………………….
Mobile No: ...……………………………………. / Mobile No: ...…………………………………….

DECLARATION

I declare that the information I have given on this form is, to the best of my knowledge, true and complete.

I understand that if it is subsequently discovered that any statement is false or misleading, or if I have

withheld any relevant information, my application may be disqualified or, if I have already been appointed,

I may be dismissed.

I hereby give my consent to the Company processing the data supplied on this application form for the purpose of recruitment and selection.

Signature ………………………………………………………… Date …………………………

Please return to: / HR department
Triton Showers
Triton Road
Nuneaton
Warwickshire
CV11 4NR / Tel No. 024 7634 4441
Fax No. 024 7634 9828

Triton Showers is a division of Norcros Group (Holdings) Limited

CF1.3/May15