Do you have a current driving licence?

Yes No

Do you have any current endorsements?

Yes No

Do you have access to a car?

Yes No

If this is your first job, or you have only had one previous employer, fill this section in with "N/A" where it doesn't apply.

Have you ever been dismissed by an employer?

Yes No

Have you ever been convicted of a criminal offence?

Yes No

Please give two people to whom reference may be made concerning your suitability for the post. The first referee should be your present or most recent employer; they should NOT be relatives or personal friends. If you do not wish for these references to be sought until after interview, tick the box below each one.

Do not contact until after interview Do not contact until after interview

In accordance with the Data Protection Act, you should be aware that the personnel details submitted with this application form will be used only for selection and interview procedures, and for employment records if the application is successful.

I declare that the information in this form is true and complete. Any false or misleading statement may be sufficient cause for rejection or, if employed, dismissal. *