imago application

7/31/2019 Imago Application

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-irn a9a services

Applicc!tion Form for Manual StaffPrivate & Confidential- Please Complete with care in black ink

Position Applied For ~(you may tick more than one box) Job t~le(s){a)j &nic e A c l v \ 5 o ( , 1()p\ CCUieey f\_>"'i~+ 'Accommodation D Catering 0 BarsD Other [J. - (please specify)Personal Details - ,_' , " ',_ -. - " , ,.~.

Title: Sumame: A{)~e;\o\l Forename-(s): La..clar;&L.......Loughborough University Student ID(if applicable):_' - " - 1 5. . . .- = Q - ' 1. . . 1 I - ' 3. . . . c . ; ; ; ; 2 ; ; ; ; . . ; 2 . = - . . . . . , - _ _

Address:" '1 4 O x f R : d ~ ; L o ' + f j " 'W g , , \5 ~ : :) " ,\ k~M. ~Postcode: 1.81SD R . . ~mail: {; p ~ a ~ d - e j Q \ ( - l o e s M A - a + R \h ~p ~o .c . ..u\


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Please continue on a se{larate sheet of paper, if necessarySchool I College I Professional Courses Attended

School I Colleges Attended .La.ocaskr ' R ~ J ' GrC, J l1 t11At S l.J ,. { (i-te w >J s\ 'O w 4 v 6 \ > ~a{~k' C n l W a R (6C;SE \

Qualifications Obtained,A U , Uaf( .S I f 1 . r /wJ. )0 i6s & . e & a " 1 c . s Date~ (008-\ l id, to10,

~ 2C06-v & 6 2()~8

, Employ,met;lt History'. '" ":," " (" :.' " ' " .' ' ' ". " . ': ,, J I ) "

Name & Address of Current Employer Start/Leave Summary, o f D u tie s + reason for .Rate of PayDates leaving-1 --'-_

Name & Address of Past Employers2 L 94rr.;;:Aq-- ~ c ; : r ~ l ' N l r Sck(\

(v-ih. Q . ,l : ~ ( . t A n . 9"X::w~~\( . r e Iw r : : \s > Q&L~~ks>V\..) . .3 . \.\e.f~ .\:' ~+d..\ V~~\ 1~6...

ReferencesPlease provide two referees who have Known you at work or as a member of the community for at .least 5 years. References are normally approached before interview. Please tick the box below ifyou wish to be consulted before a referee is contacted.NAMEo 1 ~()'f1j ~rnQ_\\ A D D R E S S CONT I\T NUMBER. D e . l t eJ . ;~ W T t o~ ,LeGS, 0(524 S fS060S

~CG..">~ ' LA l~Q_POSITION -

De r e J c f R ' \( , Q J ! + .D f - P a r - '

Have you been convicted of a cnminal offence? 't!$1@Please delete, as appropriate)(excluding those spent under the Rehabilitation of Offenders Act)If YES, please state: -'-- ..,--__- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -I certify to the .best of my knowledge alYthe information I have given is complete and correct andagree that if offered a post, references ~maybe taken up with m y present and previous employers.Signature:~ dac~ Date; - jO/oS/ZtJ" IgRETl)RN YOUR COMPLETED APPLICATION FORM TO: ,Human Resources Section, imago Services, Loughborough University, Leicestershire, LE11 3TU.Tel: 01509222379/01509223883 . '

I

Y Anthony Glass Lecturer01509 222704Loughborough Uni

Sir Richard Morris Building


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EQ UAL OPPO RTUN IT IES M ONITOR ING FORMimaqo-STRICTLY CONFIDENTIA l -

Please see guidelines.overleaf for completipg this form

DISABILITY Do you consider yourselfto be disabled: Yes0 NO~

Irish o

Title M.t. Sumame .A(\~~gy' ...................... First Name(s) . I n . k . x ; . a : u : : : .POSitio~A pp lie d Fo r W u J . e . c : < if known)

If yes, can you please give details of the nature of your disability: ..

(Please tick one box in each main section, as appropriate)GENDER Male Ii::( Female Dre you:

.. .. .. .. 0- 0-'''' ' " "_" ;, ~ .

If you think you may need assistance with regard to your disability, please contact theOperations Manager on 01509 633007.

1 _ \ ~RAC IA L GROUPS (The categories in tnts.sectlon are the same as those in the 2001 census)

WHITE: British 0White Other ~Caribbean 0Black Other 0Indian DBangladeshi 0Asian Other 0White & Black DCaribbeanWhite & Asian DMixed Other D

B LA CK O R B LA CK B RITISH :

A SIA N O R A SIA N B RITISH :

M IX ED PAR EN TAGE:

please specify . 1 > . ~ 'a . o ."African D,

please specify ,;; .. Pakistani DChinese 0

. please specify : _ - .White & Black0.African ,

please specify .- .

IIII

OTH~R ETHN IC BACKGROUND: D please specify ~~............. 'N OT K NOWN D.

,I

Call Centre Advisor, and Pool Concierge Assistant

imago application

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