Application for Employment

Address:

Postcode: National Insurance Number:

Telephone Number: Mobile / Work Number:

Next of Kin: Relationship: Telephone Number:

Date of Birth: Email Address:


Ethinic Origin:

Nationality:

Are you eligible for employment in the UK? Yes No

Is your ability to perform the particular job for which you are applying limited in any way? Yes No

If so, how can we overcome this?


Do you consider yourself under the Disability Discrimination Act (DDA)?	Yes		No

Do you have a current driving licence? Yes No

How many days have you been off work over the past 12 months through a sickness or injury?

Have you ever been convicted of a criminal offence, other than a spent convication under

the Rehabilitation of Offenders Act 1974? Yes No

Would you like to work full time? Yes No

Part time, state days/hours:

If offered this position, will you continue to work in any other capacity?

Salary required:

Have you previously worked for browns? Yes No

If YES, when?

On what date would you be available for work / length of notice required by present employer?.

Have you any holiday commitments? If so, please give dates.


Education

School		Examination and Results


College/University		Examination and Results


Further Education & Formal Traning		Examination and Results

Professional membership and qualifications:


Employment History

Please list your present and past employers, beginning with the most recent:

Include: Name & Address of Employer, Salary and Benefits, Position & Main Duties, Reason for Leaving


References
Your present employer will not be asked for a reference unless you are offered a post.

1:
Contact Name:
Company:
Address:
Telephone:
2:
Contact Name:
Company:
Address:
Telephone:


Declaration

	I declare that all of the information given on this form is to the best of my knowledge, complete and correct and agree that, if offered a post, references may be taken up with my present employers. I understand that any offer of employment is subject to my application details proving correct. By submitting this form I consent to Browns using and keeping information relating to me, provided by me or third parties, for references, relating to my application form or future employment.

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BROWNS, DAVYGATE, YORK YO1 8QT

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