Education History

    Employment History


    Please note here the names and addresses of two persons from whom we may obtain both character and work experience references.

    Other Employment

    Please note any other employment you would continue with if you were to be successful in obtaining this position.


    Please note here your leisure interests, sports and hobbies, other pastimes etc.

    Criminal Record

    Please note any criminal convictions except those ‘spent’ under Rehabilitation of Offenders Act 1974. If none please state.

    General Comments

    Please detail here your specific reasons for this application, your main achievements to date and the strengths you would bring to this post.

    Health Details

    Declaration (Please read this carefully before submitting this application)

    I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.

    I agree that the organisation reserves the right to require me to undergo a medical examination (Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor).

    Alternative Cleaning