Registration Form

Please complete as fully as you can.
Schools/Colleges/Centres Courses/Exams/Training
Please tick Previous experience and Skills
Days of work
Shift Pattern days
Do you wish to work full time?
(If yes, please tick yes)
Your reasons for leaving or wishing to leave your current/last employer will be discussed with you at interview to ensure we are able to meet any career aspirations you may have.
Please give details of previous employment, including dates, positions, salaries, responsibilities and reasons for leaving (attach additional sheets if necessary).
Length of Service Name of Employer Position and Responsibilities Salary
Please give any further information, not previously covered, that you may feel is important to support your application for the position. This may include skills, knowledge, interests, personal attributes or ambitions.
Rehabilitation of Offenders Act 1974
You are not required to disclose convictions which are “spent”. Please note that “unspent” cautions, reprimands, final warnings or convictions will not necessarily disqualify you from the position.

Do you have any cautions, reprimands, final warnings or convictions that are not ‘protected’?

Please provide details of any unspent cautions, reprimands, final warnings or convictions against you giving date, type of offence, sentence/fine imposed etc.

Please note: If the position you are applying for is exempt from the provisions of the Rehabilitation of Offenders Act 1974, you will be required to complete a criminal records check, through the Disclosure and Barring Service. We will confirm if this is required during the interview stage.
If you require any particular arrangements when attending an interview please provide details here:
Please give 2 references including your current or last employer. Please note that job offers are subject to receiving satisfactory references. References will not be taken prior to your interview.
Reference 1   Reference 2
UNDERTAKING: (Please read and sign the following undertaking.)
I confirm that the entries I have made on this application form are, to the best of my knowledge and belief, true in all respects. I understand that, should I have deliberately made a false statement on this form, any job offer could be withdrawn.

I authorise the Company to obtain references to support this application once an offer has been made and accepted and release the Company and referees from any liability caused by giving and receiving information.

I agree to the processing of personal information, including sensitive information as defined under the Data Protection Act 1998 that I may have identified or volunteered in the completion of this form.


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