British Midland Regional Limited Cabin Crew Employment Application Form

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1 British Midland Regional Limited Cabin Crew Employment Application Form Please complete this form clearly and accurately, giving as many details as possible of your skills and experience relating to this job application. Short listing will largely be based on the information gathered from this form; you will be advised of the outcome of your application. We are proud to be an Equal Opportunities Employer. This form should be scanned and ed to Please include a covering letter detailing your reasons for wishing to join bmi regional as Cabin Crew and attach a recent full-length photograph of yourself. PREFERRED BASE Please indicate below your preference of airports that you would prefer to work from, by numbering 1 for first choice, 2 for second choice, and so on. Aberdeen: Bristol: Birmingham: Derry: Newcastle: Munich: Karlstad: PERSONAL DETAILS Title: Date of Birth: National Insurance Number: Address (including postcode): Forename(s) as appears on passport: Surname as appears on passport: Known as name (if different to above): Nationality: Correspondence Address (if different): Contact Telephone Numbers Home: Mobile: Daytime: Personal Address: Do you hold a full current Driving Licence? If, please provide Driving Licence Number: Passport Details: Do you have the right to work in the UK without restriction? NB: If you are invited to interview with British Midland Regional Limited, you will be required to provide evidence of your entitlement to work in the United Kingdom at this time. Where did you hear about this vacancy?.: Expiry Date: If, please give details: Page 1 of 9

2 EDUCATION DETAILS Name of School/college/university/ training body Subject Studied Qualification/ Level Attained Date Attained ADDITIONAL SKILLS/TRAINING Training Course/Skill Date Do you hold a Cabin Crew Attestation? If, from which Company?: LANGUAGES Language Level of Proficiency BASIC HEALTH DETAILS It is important for all Cabin Crew to be physically able to carry out all safety duties on board our aircraft. Are you aware of any physical disability or health problems that could affect this application? Do you hold a Cabin Crew Medical in accordance with EASA Part MED? If, please give details: If, please provide details: Please state your Height (without shoes): Please state your weight (without clothing): Do you wear glasses / contact lenses? What is your weekly consumption of alcohol? Do you smoke? Page 2 of 9

3 FURTHER HEALTH DETAILS bmi regional operate aircraft that require either one or at the most two cabin crew. As such, our medical criteria for selection is necessarily more stringent than that required for operations where multiple cabin crew is the norm. Are you currently suffering from or have suffered from any of the illnesses listed below: Please answer YES or NO. Deafness, ear ache or ear disorder Anaemia or other blood disorders Hay fever or other allergy Heart or other vascular trouble Neurological disorders; stroke, epilepsy, seizure, paralysis etc Diabetes, hormone disorder Skin disease Motion sickness requiring medication Sickle cell trait (personally or in family history) Frequent or severe headaches Unconsciousness for any reason Chronic back pain, lumbago, sciatica or slipped disc etc. Alcohol/drug/substance abuse Pneumothorax Head injury or concussion Asthma, lung disease or other chest disorders Admission to hospital Kidney stone or blood in urine Stomach, liver or intestinal trouble Eye trouble/eye operation se, throat or speech disorder Malaria or other tropical diseases Dizziness or fainting spells High or low blood pressure Condition resulting in difficulty sleeping Frequent cold or sinus trouble Adequate vision with or without glasses Visit to medical practitioner in the last 12 months (if yes, please write reason in the remarks box) Page 3 of 9

4 Have you been prescribed any antibiotics in the last 12 months (and if so, what for?)? Suffered from psychological illness, anxiety, depression, stress or other disorders Any other illness that may affect fitness at work (please describe in the remarks box) FEMALES ONLY: Gynaecological, menstrual problems FEMALES ONLY: Are you pregnant? Please confirm the number of days sickness absence from work you have had in the last: Are you currently taking prescribed medicine? Are you currently under the care of a doctor or other medical professional? Has your employment ever been terminated on the grounds of ill health? Name and address of GP: 12 months: 24 months: If you have answered yes to any of the above questions, please give details below and approximate dates where relevant. This is particularly important where you have a qualifying disability under the Disability Discrimination Act 1995, as it will enable us to identify what, if any, reasonable adjustments can be made. Remarks Page 4 of 9

5 REFERENCE DETAILS PLEASE READ THE FOLLOWING NOTES CAREFULLY. IF THIS SECTION OF THE FORM IS NOT COMPLETED FULLY AND ACCURATELY, YOUR APPLICATION MAY BE DISCARDED. Employment by bmi regional will necessitate access to sensitive areas of airports and a security ID pass will be required. In line with a Department of Transport Directive, bmi regional is required to obtain references from your previous employer(s). You must provide details of all previous employment covering the five year period prior to joining bmi regional. If you have any gaps in employment dates, please provide a full explanation and state a relevant referee to verify the gap period. This reference must be supplied by someone who has known you for over two years, must not be a relative or co-habitee and someone you see on a regular basis. The character reference must be supplied by someone who has known you for over five years, and someone you see on a regular basis. The character referee must NOT be a relative or cohabitee. If you have never been in full time employment, you should give details of University, College, School or Unemployment Benefits Office along with contact details of a representative from these establishments who could be used as a referee. Should none of these apply, please provide details of a referee who could verify the five year period. This reference must be supplied by someone who has known you for over five years, must not be a relative or co-habitee and someone you see on a regular basis. Addresses It is preferable for employment, employment agency, education and voluntary sector references to be obtained by in order to improve the speed of the reference process. addresses should contain the name of the referee, however, if this cannot be provided, generic addresses may be acceptable under certain conditions but this may prolong the reference process. Personal addresses are not acceptable. addresses are not required for gap, HMRC or Job Centre Plus references. Employment Record (Most current first) PLEASE ENSURE YOU PROVIDE THE EXACT DATES EXACT Dates of Employment From: To: Employers Name, Address, Contact Number and Address. Please also include Contact Name: Position(s) Held & Brief Description of Nature of Work: Reason for Leaving: Page 5 of 9

6 Employment Record (Continued) EXACT Dates of Employment From: To: Employers Name, Address, Contact Number and Address. Please also include Contact Name: Position(s) Held & Brief Description of Nature of Work: Reason for Leaving: Page 6 of 9

7 Employment Record (Continued) EXACT Dates of Employment From: To: Employers Name, Address, Contact Number and Address. Please also include Contact Name: Position(s) Held & Brief Description of Nature of Work: Reason for Leaving: Page 7 of 9

8 Character Reference Please supply the name, address and contact number(s) for a character reference. Character referee must: be known for 5 years, not related & not co-habiting. Name, Address & Contact Number of Referee Number of Years Referee has Known You: Gaps In Employment Please explain FULLY the reason for any Gaps in Employment. accurately, your application may be discarded. If not completed fully and Please ensure you provide the exact dates. Dates () Reason Please supply name(s), address(s) and contact number(s) of the gap referee(s) who could verify the above periods. Name, Address and Contact. of Referee Dates Verified By providing details of previous employers and/or referees, and in signing this Application Form, you are providing your express consent to the Company approaching any/all of those parties for the purpose of obtaining a reference. Page 8 of 9

9 FURTHER DETAILS REGARDING PRESENT EMPLOYMENT How much notice do you need to give your current employer? If you are applying from another department within bmi, please indicate your current salary / grade. Internal candidates should advise their manager that they have applied for another post in the organisation. Please confirm you completed the relevant form in this respect. RELEVANT EXPERIENCE/SKILLS Please let us know in no more than 100 words why you consider you are suitable for the position of Cabin Crew. If you have flying experience, which a/c types have you flown on? DECLARATION & SIGNATURE I certify that all the information contained in this form and any attachment is true and accurate to the best of my knowledge and I have no criminal convictions other than any treated as spent under the provisions of the Rehabilitation of Offenders Act 1974 and those disclosed on this form. I realise that false information or omissions may lead to my application being discarded or dismissal from any employment subsequently taken up by me with British Midland Regional Limited and acceptance that any misrepresentation of the facts is a ground for refusal of employment or disciplinary proceedings (and, in appropriate cases, criminal charges) Signed Date. DATA PROTECTION ACT bmi regional is a Data Controller in terms of the Data Protection Act 1998, and you have the right to ask for a copy of the information held by us in our records in return for payment of a small fee. You also have the right to require us to correct any inaccuracies in the information we hold on you. If your application is successful, the information you have provided will be held on our records and may be used for personnel administration, learning, discipline, absence management, career development, statistical and payroll purposes. If you are not offered employment, all documentation related to your application for employment will normally be confidentially destroyed after a period of six months. Please return your completed Application Form to: careers@bmiregional.com Page 9 of 9

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