PERSONAL DETAILS  
    Age      
  Account status      
  Work in UK eligibility        
             
  Sex        
  Martital status        
  Title        
  Forename Address    
  Surname      
  DOB (DD/MM/YYYY)      
  Home Telephone      
  Mobile Telephone      
  Email      
  National Insurance No. Postcode    
      Country    
  Full UK driving licence Credit card owner    
  Driving licence points
or convictions etc.
   
             
  Current Salary Package including benefits & holidays    
           
    You are required to provide evidence of the above details at your interview, by bringing
along with you the following as proof:
   
      Do you have proof ?    
    Eligibility to work in the UK (Passport / Birth Certificate etc)    
    Driving Licence & Counterpart    
    Your last 3 months wage slips    
    Last years P60 (Sales roles only)    
    Current holiday entitlement    
    Credit Card or ability to obtain one (Sales roles only)    
         
  REHABILITATION OF OFFENDERS ACT  
         
    Have you ever been convicted of a criminal offence?    
    Have you any prosecutions pending?    
           
    If yes, please give details / dates of offence(s) and sentence:      
       
           
  HEALTH    
    Number of days absent in the last 2 years:    
    Number of times in the last 2 years:    
    Are you registered disabled ?    
    If yes please provide your disability number and details:      
         
       
           
  EDUCATION        
         
 
 No. Date From Date To Name of School Examinations taken and Qualifications Gained Grades
1
2
3
4
5
6
7
8
9
10
           
 
     
  EMPLOYMENT RECORD      
     
  Please list chronologically, starting with current or last employer  
     
No. Name and
Address of employer
Date
From
Date
To
Job Title/Job Function/
Responsibilities
Salary and
Reason for Leaving
1
2  
3  
4  
5  
6  
7  
8  
9  
10  
           
 
     
           
  PERSONAL ATTRIBUTES  
     
           
    Use this section to add any further information which directly relates to your suitability for this position.  
  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   Reference 2
Name  
Their Position (job title)  
Work Relationship  
Organisation  
Dates Employed      
From     
To     
Address  
   
   
   
   
Postcode  
Telephone  
E-mail  
       
       
 
           
  DECLARATION  
  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.  
           
  SIGNED DATE
DD/MM/YYYY
 
  Stallion Recruitment Limited 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, Stallion Recruitment Limited 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.  
           
  RECRUITMENT MONITERING FORM      
  This section will be separated from your application form upon receipt and does not form part of the selection process. It will be retained by the Human Resources purely for monitoring purposes.

To help us ensure that our Equal Opportunities Policy is fully and fairly implemented please COMPLETE THIS SECTION OF THE APPLICATION FORM.
 
       
  What is your Ethnic Group?    
  A. White  
  B. Mixed  
  C. Asian or Asian British  
  D. Black or Black British  
  E. Chinese or other ethnic group  
  F. I do not wish to provide this information  

     
 
 

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