APPLICATION FOR EMPLOYMENT – COMPANY GENERAL MANAGERPlease complete this form as fully as possible. Use additional sheets of paper if necessary.

PERSONAL DETAILSTitle: Forename(s): Surname:

Address:

Postcode: E-mail:

Telephone (Day): Telephone (Evening):

REFERENCESPlease provide details of two referees, one should be your current or most recent employer.Name: Name:

Address: Address:

Tel: Tel:

Email: Email:

Occupation: Occupation:

Relationship to you: Relationship to you:

May we contact this referee prior to offer of interview? Yes No

May we contact this referee prior to offer of interview? Yes No

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EMPLOYMENT HISTORYPlease list all relevant employment history, starting with your present or most recent employer.Employer name:

Employer address:

Job title: From (MM/YY): To (MM/YY):

Period of notice required:

Reason for leaving:

Main duties/responsibilities:

Employer name:

Job title: From (MM/YY): To (MM/YY):

Reason for leaving:

Main duties/responsibilities:

Employer name:

Job title: From (MM/YY): To (MM/YY):

Reason for leaving:

Main duties/responsibilities

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SKILLS, QUALIFICATIONS, INTERESTSPlease list any other skills, qualifications or interests which are relevant to the post.

EDUCATIONPlease provide details of your education including dates, qualifications gained and grades achieved.

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TRAINING, SEMINARS AND PROFESSIONAL BODIESPlease provide details of any relevant training courses or seminars that you have attended or professional bodies of which you are a member.

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SUPPORTING STATEMENTPlease explain why you would like this post, stating what qualities you think you can bring to the job, and give any additional information you feel supports your application. This will enable us to see how your particular skills and experience match up to the requirements of the job. It is, therefore, important that you tell us as much as possible about yourself in relation to the Job Description and the items listed in the Person Specification (continue on a separate sheet if necessary).

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ELIGIBILITY TO WORK IN THE UKDo you require a work permit to work in the UK? Yes No

If yes, what type of permit is it?

Date of issue: Date of expiry:

Visa number: Passport number:

Place of issue:

To ensure compliance with Section 8 of the Asylum and Immigration Act 1996, all candidates will be required to provide proof of their eligibility to work within the UK at interview stage.

Rehabilitation of Offenders Act, 1974Please provide details of any convictions of a criminal offence other than a spent conviction under the Rehabilitation of Offenders Act 1974 and the Rehabilitation of Offenders (Northern Ireland) Order 1978.

Date:     

Offence:     

Penalty:     

Declaration

The personal information collected on this form will be used for the purposes of recruitment and selection for the role or roles you have applied for and if appoin-ted will form part of your employment record. The information will not be used for any other purpose nor will it be disclosed to any third party. Please confirm by signing below that you give your consent for your information to be used by curious directive for recruitment purposes.

I confirm that the information given on this form is, to the best of my knowledge, true and complete. I understand that any deliberate attempt to provide false information to obtain employment is a serious misrepresentation and will lead to rejection, or if employed, dismissal. I understand that if I am invited for interview any relevant criminal convictions may be discussed in order to assess job-related risks.

Signed: Date:

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Print name:

curious directive: Equal Opportunities Monitoring Form curious directive is committed to being an equal opportunities employer. This monitoring form is for the collation of statistics only and will be kept separately from your application. curious directive does not have wheelchair accessible offices but aspires to provide the best possible facilities, given the offices’ restrictions, for people with other disabilities.

How would you describe your ethnic origin? (These codes have been classified by The Equality and Human Rights Commission. Choose ONE section from A to E, and then tick the appropriate box to indicate your cultural background.)

SECTION A: WHITE ( ) British ( ) Irish ( ) Any other white background, please give details…………………………………….

SECTION B: DUAL HERITAGE ( ) Asian and White ( ) Black African and White ( ) Black Caribbean and White ( ) Chinese and White ( ) Any other background from more than one ethnic group, please give details...........................

SECTION C: ASIAN OR ASIAN BRITISH ( ) Asian Indian ( ) Asian Pakistani ( ) Asian Bangladeshi ( ) Any other Asian background, please give details ……………………………………

SECTION D: BLACK OR BLACK BRITISH ( ) Black - Caribbean ( ) Black - African ( ) Any other Black background, please give details ……………………………………

SECTION E: CHINESE OR OTHER ETHNIC GROUP ( ) Chinese ( ) Any other Ethnic group, please give details …………………………………………

Please indicate your gender: Female Male

Do you consider yourself to have a disability? Yes No

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Are you registered as disabled? Yes No

Please indicate your age: 18 - 25 45 - 55 25 - 35 55 - 65 35 - 45 Over 65

Date of birth: ..............................................

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