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Occupational Personnel Services Ltd

Clapton Business Centre

109E Downs Road

Clapton, London E5 8DS

CONFIDENTIAL
Application for employment

Position applied for

personal details

 Address: 

City:

Post Code:

Telephone number:

Mobile number:

Email:

Date of Birth:

Nationality:

National Insurance Number:

Do you hold a full driving licence?

If yes, give your licence number

Do you have access to a car or motorcycle

Next of kin:

Name:

Relationship to you:

Address:

Post Code

Home telephone number:

Mobile number:

HEALTH

How would you describe your current health (Excellent = fit with no known problems.  Poor = Existing that limit your everyday activities)

Please state your condition and list medicines that are currently prescribed for you. 

MEDICATION

BANK details

Bank name:

Sort Code:

Your name (exactly as it appears on your bank card):

Account number:

EMPLOYMENT details

We need a full employment history for the past 10 years or from leaving full time education if that was less than 10 years ago. Any employment gaps of more than a month must be shown and explained.

1.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

2.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

3.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

4.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

5.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

6.   Company Name and Address

Post Code:

Job Title:

Dates: From (mm/yyy)

Dates: To (mm/yyy)

qualification

Details of relevant qualifications and courses passed. Give most recent dates only for repeated courses.

You may be asked to show your certificates as evidence.

Date

Examination / Course

School / College / University / Employer

Grade

State which language you speak and the level of fluency (Beginner or Advance [Conversational])

Language

Fluency

Occupational Personal Services Ltd undertakes that it will treat any personal information that you provide to us, or that we obtain from you, in accordance with the requirements of the Data Protection Act 1998.

By signing this form, I consent to the company keeping paper and computer employment records, and may be used  for internal management purposes and externally for the purposes of placing me in temporary or permanent roles and to report my compensaion and renumeration to the relevant authorities.

By signing this form, I confirm that I understand my right to opt out of the 48 hour working week limitation as set out in the Working Time Regulations 1998 (WTR).

I wish to opt out of the WTR 

I understand I may change this by giving one week's notice in writing to my Manager.

NOTES (For office use ONLY)

We need two previous employer reference (one must be the current/most recent employer) plus one character reference.  The character reference must be from someone (not a relative) you must have known for at least two years.

Company Name:

Contact Name:

Telephone Number

Company Name and Address

Post Code:

Company Name:

Contact Name:

Telephone Number

Company Name and Address

Post Code:

Character Reference

A character reference needs to be provided by a person of standing in the community who is not your relative, and has known you for at least three years or more. This means that your referee must have a reputation in the community. A professional person (e.g. a doctor, solicitor or accountant) will be recognised as a person of standing in the community as will a Bank manager; Justice of the Peace or other judicial official; or Minister of the Church, Rabbi, Imam or other religious official. This is not an exhaustive list.

Have you ever been convicted of a criminal offence

 

At the time of signing this form is there any prosecution pending or has anything occurred that may result in a prosecution?

 

 

If you have ticked either yes box please give details on a separate sheet.

 

I, the undersigned, undertake to inform Occupational Personnel Services Ltd of anything which occurs at any time during my employment hat may result in a prosecution.

Occupational Personnel Services Ltd can offer employment to non-British citizens and non-EEA nationals only with proof of eligibility to work in the UK

Passport number:

Date Issued:

Passport nationality:

Passport Expiry Date

I confirm that the information provided in this application and within my personal statement is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file.

Signed (Applicant):

Date:

WORKING TIME REGULATIONS

Name:

Telephone number:

Relationship:

REHABILITATION OF OFFENDERS ACT 1974

PERSONAL DETAILS

EQUALITY & DIVERSITY

OUR COMMITMENT TO EQUAL OPPORTUNITIES

This section of the application form will be detached from your application and will be used solely for monitoring purposes Occupational Personnel Services Ltd is committed to its Equal Opportunity Policy and assesses all job applicants without regard to disability, race, gender, age, sexual orientation, religion or belief. To enable the Company to adhere to this policy this application form includes questions relating to these topics and are no obligatory. This information shall be kept separate to your application.

Age

Date of Birth:

Gender

 (Please Specific)

Religion

 (Please Specific)

Other (Please specify)

Sexual Orientation

 (Please Specific)

Ethnic Origin

Other (Please specify)

Review Application before submitting

Submit your CV

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Thank you for Submitting

data protection act 1998

references

declaration

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