Name

Location

Personal Details

Title Mr Mrs Miss Ms Dr

Forenames*

Surname*

Address

Postcode

Contact number*

E-mail

Homeowner Yes   No  

NI Number

Country of birth Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Côte D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island And Mcdonald Islands Holy See (vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic Of Iraq Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Bartholemy Saint Helena Saint Kitts And Nevis Saint Lucia Saint Martin Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe

Work permit required Yes   No  

Previous addresses For the purposes of the Asylum and Immigration Act 1996, please give details of all addresses you have lived at during the past five years (not including the above)

Current driving licence Yes   No  

Endorsements Please give details of any driving endorsements

Sickness How many days sick have you had off work in the last 12 months of employment? (Please give reasons for absence)

Absenteeism If applicable, on how many occasions were you absent for 3 or more days?

Previous Employment Yes   No   Have you worked for Manning Stainton previously?

Acquaintances Yes   No   Do you have a relative or acquaintance who works (or has worked) at Manning Stainton?

Criminal Offences Yes   No   Have you ever been convicted of a criminal offence or is any prosecution pending (excluding minor driving convictions) by a civil or criminal court? (Declaration is subject to the Rehabilitation of Offenders Act 1974).

Disciplinary Procedures Yes   No   Have you ever been subject to any action taken under disciplinary procedures by an employer or dismissed from employment?

If yes, please give details

Education History

Schools Please list schools attended, dates and qualifications gained.

College/University Please list colleges/universities attended, dates and qualifications gained.

Professional Qualifications Please give details of any Professional Qualifications or Membership of Professional Institutions

Previous Training Please give details of any specialised training received and/or courses attended

Ongoing Training Please give details of any current/ongoing training

Employment History

Current Position Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

Notice period Notice period required in current position.

Previous Position 1 Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

Previous Position 2 Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

Previous Position 3 Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

Previous Position 4 Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

Previous Position 5 Please give details of employment dates, employer name and address, job title and duties, final salary, reason for leaving.

References

Please note references will not be taken up prior to an offer of employment being made. Please provide the names and addresses from whom the company may obtain both character and work experience references. One reference should be from your current employer.

Reference 1

Reference 2

Further Information

Leisure Please note here your leisure interests, sports and hobbies, other pastimes etc.

Other Skills (e.g. languages, computer keyboard skills etc.)

Continuing Employment Please provide information about any additional work outside your full-time employment (please note under the ‘Working Time Directive’ you are obliged to notify the Company)

Personal Qualities Briefly describe any personal qualities you believe you possess for the position you are applying for

Application Support Please add any information you feel will support your application

Holidays Booked Please give dates of any holidays booked for this year

Interview Dates Are there any dates you are unavailable for interview?

Special Arrangements

Start Date When would you be able to start work if offered a position?

Current/Final Salary Please state your current/final salary per annum based on number of hours worked per week

Required Salary Please state your required salary (per annum / per week)

Attach CV Please attach your CV here. Microsoft Word or PDF format.

Equal Opportunity Monitoring - Optional

We are an equal opportunity employer. The aim of our policy is to ensure that no job applicant or employee receives less favourable treatment on the grounds of race, colour, creed, nationality, ethnic or national origin, religious belief, political opinion or affiliation, sex, marital status, sexual orientation or disability, or is disadvantaged by conditions or requirements which cannot be shown to be justifiable.

Our selection criteria and procedures are frequently reviewed to ensure that individuals are selected, promoted and treated on the basis of their relevant merits and abilities.

All employees are given equal opportunity and are encouraged to progress within the organisation.

We are committed to an ongoing programme of action to make this policy fully effective. To ensure that this policy is fully and fairly implemented and monitored, and for no other reason, would you please provide the following information.

PLEASE NOTE THIS SECTION IS OPTIONAL AND IF COMPLETED, WILL BE LOOKED AT INDEPENDENTLY FROM YOUR APPLICATION AND WILL HAVE NO BEARING ON IT

Ethnic Origin White   Black - Caribbean   Black - African   Black - other (please specify)   Indian   Pakistani   Bangladeshi   Chinese   Other (please specify)  

Other ethnic origin

Gender Male   Female  

Marital Status

Date of Birth

Referral Where did you see this vacancy?

Declaration

Please read this carefully before sending this application.

"I confirm that the information given on this application form is correct and accept that providing deliberate, false information could result in my immediate dismissal if offered a position with the Company. In the interest of security I agree to abide by the company’s search procedure.

I understand that any offer may be conditional on the results of a medical examination that the Company may wish to carry out. Completion of this form in no way binds the Company to offer me employment and that no contractual relations will exist between the two parties until such time as I have signed a form of contract or accept in writing the terms of a letter of appointment.

I have also read and understand the guidelines relating to use of data from information given in this form."

I agree* By ticking this box you confirm that you have read and understand the declaration above.

Full name*

Date*

Authentication*

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