01995 603555 sales@coars.co.uk

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Position

Prefix

First name

Surname

Address

Postcode

Date of Birth

Tel No.

Email Address

Drivers License

Yes

Details of Current Endorsements

Schools/Colleges (Qualifications)

Other Training

Previous Employment

Employer 1

Dates (From - To)

Name and Address of Employer

Job Title

Wage/Salary

Reason for Leaving

Employer 2

Dates (From - To)

Name and Address of Employer

Job Title

Wage/Salary

Reason for Leaving

Employer 3

Dates (From - To)

Name and Address of Employer

Job Title

Wage/Salary

Reason for Leaving

Current Notice Required

Salary Now Required

References

Do you have a mental or physical disability?

Yes

If yes, please give details:

What adjustments (if any) need to be made to the working environment to accommodate your disability?

Please give details of all absences from work for the last 12 months.

Leisure (Please note any sports, hobbies, pastimes etc.)

Criminal Record

Please note any criminal convictions except those ‘spent’ under the Rehabilitation of Offenders Act 1974. If none please state:

General Comments

Data Protection Notification

Signed

The information you have provided in completing this application form will be used to process your application for employment. The Company will keep the information you have supplied confidential and will not divulge it to third parties, except where required by law, or where we retained the services of a third party representative to act on your/our behalf. AUTHORISATION : I have read the Data Protection notification and understand and agree to the use of my personal data in accordance with the Data Protection Act 1998.

Date

Confirm

Signed

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

Date

Registered Address: Chandler House, 7 Ferry Road Office Park, Riversway, Preston, Lancashire, PR2 2YH
Registered in England | Company Number: 03431705