Scribd
Upload
13 views

Blank Application Form-5

Uploaded by

ws7zc8c299
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
13 views

Blank Application Form-5

Uploaded by

ws7zc8c299
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

Employment Application Form Store: Derby

All sections must be completed in order for your application to be considered.

Position Applied For:(tick one) Manager □ Supervisor □ Baker □Counter-hand □


(select one) Full time □ Part-time □
How did you hear about the position?

PERSONAL DETAILS

Surname Forename(s)
Address Postcode
Tel. No. (Home) (Mobile)
Date of Birth Age National Insurance No

Are you legally entitled to work in the U.K.? YES □ NO □ Email Address:

How far do you live from the: Intu (Derby) Centre?


How would you get to and from work?

Do you have any holidays booked within the next 12 months? YES □ NO □ If yes please specify

AVAILABILITY TO WORK

Please complete the chart below to indicate the times within which you are available to be rostered each week.
Complete this section carefully as the availability that you declare is fixed and you will be expected to work any
shift that you are rostered for within your declared availability, up to your weekly maximum. Hours are
determined weekly in advance.
Muffin Break Derby’s working hours are between 5am and 10pm; seven days per week (although extended
trading hours may apply during the Christmas holiday period).

MON TUE WED THUR FRI SAT SUN


Time from
Time to

What is the maximum number of hours you wish to work each week?
Could you work extra hours if required? YES □ NO □
If you are a student are you willing to work extra hours in your holidays? YES □ NO □
HEALTH

Have you had any injury or medical condition caused by gradual process, disease or infection that the tasks of
this job e.g. lifting, bending, standing for extended periods, wearing gloves may contribute to? YES □ NO □
If yes please detail

Do you suffer from any disease or ailment which may affect your work performance or regular attendance at
work e.g. asthma? YES □ NO □ If yes please detail

In addition to the information provided above is there any information that Muffin Break should know to assess
your suitability for employment and/or ability to do the job? YES □ NO □ If yes please detail

17/03/02
PRESENT AND PREVIOUS EMPLOYMENT

Please give full details of your past two employers, including the details for a referee for each position held.
Please note, we will contact your referee prior to arranging an interview.
1. Employers Name Address
Employed From: to City/Postcode
Job Title and Duties
Reason for leaving
Referees Name/position
Tel. No.

2. Employers Name Address


Employed From: to City/Postcode
Job Title and Duties
Reason for leaving
Referees Name/position
Tel. No.

GENERAL EDUCATION AND TRAINING

School/college/university
Subjects studied
Date from to Exams/awards/achievements

HOBBIES AND INTERESTS

Please detail hobbies, interests or membership of clubs or societies

CRIMINAL CONVICTIONS

Have you ever been convicted of a criminal offence? YES □ NO □ If yes please detail

NEXT OF KIN (to contact in case of injury or sickness)

Name Address

Phone Relationship

My expected hourly pay rate is £

I certify that the information detailed in this application is true and correct. I understand I may be disqualified
from appointment, or if appointed dismissed, if I am found to have supplied incorrect or misleading information
or have omitted any important information.

Applicants signature Date

17/03/02

You might also like