Kellaway Building Supplies - Job Application
 
Position for which you are applying:  
Location, e.g. Branch or Department:  
PERSONAL DETAILS
Surname:
First Names:
Mr     Mrs    Ms      Miss     Other
Permanent Address:
Postcode:

Telephone Numbers:

Email Address:
National Insurance Number (if known)
Are there any restrictions on you taking up employment in the UK? Yes No
If yes please provide details:
Current Driving Licence: Yes No
Groups:      Expiry Date:
Details of endorsements / number
of points:
Details of current plant certificates
e.g. forklift, crane etc
CRIMINAL RECORD
Please note any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974. If none, please state
HEALTH DETAILS

Do you have a physical or mental impairment which has a substantial and long term effect on your ability to carry out day to day activities? Yes No

Please specify any special arrangements for work associated with any impairment

Please specify any special arrangements you will need to attend an interview

Please list any diseases and disorders, allergies, muscular or musculaskeletal injuries from which you have suffered or do suffer

Please detail any form of medicine, drugs or treatment you are currently and/or regularly receiving

Please list all absences from work in the past 12 months and the reason for such absences
EDUCATION AND TRAINING
Names of Secondary schools, Colleges, Universities attended Dates from/to Examination passes with grades and levels, degrees, technical and professional qualifications
List any recent courses attended:
CAREER / EXPERIENCE TO DATE
Name of employer, address and nature of business
Start with present/last employer		 Dates from/to Position held, brief details of duties and reason for leaving Pay and other benefits received
Notice required by your present employer or when you could commence employment:
 What pay are you seeking?

per year week hour
(select as appropriate)
Please give details of any hobbies, interests or other relevant information in support of your application:
REFERENCES
Names and addresses of two referees (not relations), one of whom should be your most recent employer. References will not be taken up until any offer of employment is accepted or your position obtained.

Name:

Address:

Telephone:

Their association with you:

Name:

Address:

Telephone:

Their association with you:
DECLARATION

I confirm that the above information is complete and correct and that any untrue or misleading information will give the employer the right to terminate any employment contract offered.

Date: