Join the team Application Form THE INFORMATION YOU SUPPLY ON THIS FORM WILL BE TREATED IN CONFIDENCE. Section 1 Personal details Position Applied For: Title: Last Name: First Names: Date of Birth: Address: Postcode: Home Telephone Number: Mobile Telephone Number: E-mail address: Are you eligible to work in the UK? YesNo Do you hold a full UK driving licence? YesNo If yes, Do you have any points or convictions Or any prosecutions pending? You are required to provide evidence of the above details at your interview by bringing with you: • Proof of eligibility to work in the UK (Passport / Birth Certificate etc) • Driving Licence & Counterpart Section 1a - Availability Please enter your earliest start time Mon Tue Wed Thurs Fri Please enter your finish time Mon Tue Wed Thurs Fri Would you be happy to work overtime if offered YesNo Section 2 - Rehabilitation of Offenders Act Have you ever been convicted of a criminal offence? YesNo Have you any prosecutions pending? YesNo If yes, please give details / dates of offence(s) and sentence: Section 3 - Health Are you registered disabled? YesNo If yes please provide your disability number and details: Section 7 - 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. (NB. References will only be taken if you commence employment with us) Reference 1 Name: Their Position (job title): Work Relationship: Organisation: Dates Employed: From: To: Address: Postcode Telephone No: E-mail: Reference 2 Name: Their Position (job title): Work Relationship: Organisation: Dates Employed:From: To: Address: Postcode Telephone No: E-mail: Section 8 - Additional Information Please use this space to tell us anything additional to support your application Section 9 - Declaration By ticking the box below I confirm that the information provided in this application and within my Curriculum Vitae is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file. By ticking this box you agree to the above Date: Light & Airey Cleaning Services undertakes that it will treat any personal information that you provide to us, or that we obtain from you, in accordance with the requirements of the Data Protection Act 1998. After initial assessment, Light & Airey Cleaning Services may keep your details on file pending suitable opportunities that may arise in the future. Please tick if you do not wish us to hold your details.