Job Application Form

1.      Personal details

Job Application Form

Vacancy Title:
Please tell us how you heard about this vacancy:

Last Name:

Keane

First Name:

Kieran

Address:

Postcode:

Home Telephone No.

Daytime Contact No.

E-mail address:

National Insurance No.

Are you free to remain and take up employment in the UK?	Yes	X	No
You will be required to provide appropriate documentary evidence of this at interview. For examples of acceptable documents please see www.ukba.homeoffice.gov.uk

Driving Licence (if relevant to post applied for) Do you hold a full, clean driving licence valid in the UK?	Yes		No	X
If no, please give details below I don’t drive.
Convictions/ Disqualifications
Upon offer of employment we reserve the right to request a Criminal Records Bureau Disclosure at Standard level and this disclosure will include details of cautions, reprimands or final warnings as well as convictions.
Please provide details below of any convictions which are not spent under the terms of the Rehabilitation of Offenders Act 1974:

2.      Education/Qualifications

School (11+)	Study Dates	Qualification  and Grade	Date Obtained
Stockland Green Secondary School
College/University	Study Dates	Qualification  and Grade	Date Obtained
Sutton Coldfield Campus James Watt College
Ongoing Professional Development	Study Dates	Qualification  and Grade	Date Obtained
James Watt College

Training and Development Please use the space below to give details of any training or non-qualification based development which is relevant to the post and supports your application.

Training Course	Course Details (including length of course/nature of training)

Current Membership of any Professional Body/Organisation

Please give details:

Employment History Previous Employment:  Please include any previous experience (paid or unpaid), starting with the most recent first.

Current or most recent employer

Name of Employer:

Address:
	Postcode:

Position Held:

Date Started:

Reason for leaving:

Salary on leaving this post:

Notice Period

Brief description of duties:

Previous employer

Name of Employer:

Address:
	Postcode:

Position Held:

Date Started:

Reason for leaving:

Salary on leaving this post:

Notice Period

Brief description of duties:

4.      References

Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your referees are.

                            Reference 1                                                                              Reference 2

Name: Job Title: Organisation: Address: Contact No: Email: How is this person known to you: Do you wish to be consulted before this referee is approached: Yes No

Name: Job Title: Organisation: Address: Contact No: Email: How is this person known to you: Do you wish to be consulted before this referee is approached: Yes No

We reserve the right to contact any of your other previous employers within the last three years.

5. Declaration

Statement to be Signed by the Applicant (Candidates selected for interview will normally be notified within four weeks of the closing date.) Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered: I agree that GFM Holdings Ltd can create and maintain computer and paper records of my personal data and that this will be processed and stored in accordance with the Data Protection Act 1998. I confirm that all the information given by me on this form is correct and accurate and I understand that if any of the information I have provided is later found to be false or misleading, any offer of employment may be withdrawn or employment terminated.

Signed:	K.Keane	Date:	03/03/2016
If you return this form by email, you will be asked to sign your application at interview

6.   Availability

Holidays Booked:

Shifts preferred:

(please number in order of preference)

3

Day (usually 9.00am – 5.30pm) :

2

Evening (usually 6.00pm – 10.00pm) :

4

Saturday (usually 9.00am – 5.30pm) :

1

Sunday (usually 10.00am – 4.00pm) :

Minimum notice needed to work:

The day before.

Do you have any regulations on hours you can work:

No.