Name *

First Name

Last Name

Do you have the right to work in the UK?

Yes

No

Do you have a full UK driving license?

Yes

No

Do you have access to a car?

Yes

No

What is your current employment status? *

Employed

Unemployed

Self-Employed

Student

Available start date: *

MM

DD

YYYY

Do you consider yourself to have a disability according to the terms given in The Equality Act 2010? *

"The Equality Act 2010 defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term (i.e. has lasted or is expected to last 12 months) and has an adverse effect on the person’s ability to carry out normal day-to-day activities."

Yes

No

Prefer not to say

*

I confirm that the information I have provided is correct.

*

I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable for dismissal.

*

I consent to the Organisation using and keeping information I have provided on this application or elsewhere as part of the recruitment process and/or personal information supplied by third parties such as referees, relating to my application or future employment. I understand that the information provided will be used to make a decision regarding my suitability for employment and if successful the information will be used to form my personnel record and will be retained for the duration of my employment. If I am not successful, I understand that the Organisation will retain the form for as long as is deemed necessary, usually for six months after the post has been filled.