Job Application Application for Employment as: Full Name: Phone #: Address: Postcode: Email: Education and Training Please describe any relevant education and training: Employment History Present/Previous Employer: Employer Address: Employer Postcode: Job Title: Duties: Pay: Length of Time With Employer: Reason for Leaving: *No approach will be made to your present employer or past employer before an offer of employment is made to you. Please tell us about other jobs you have done and about the skills you used and/or learned in those jobs: Can you provide proof of eligibility to work in the UK? YesNo Do you have a valid driver’s licence? (may not be required) YesNo Are you able to lift up to 25kg without excessive difficulty? YesNo This job may require repetitive strenuous lifting, do you have any medical condition that may hinder or be aggravated by this activity? YesNo Do you consider yourself to have a disability? YesNo Please tell us if there are any dates when you will not be available for interview: I confirm that to the best of my knowledge the information I have provided on this form is correct and I accept that providing deliberately false information could result in my dismissal. Name: Date: