JOB Application Form

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1 JOB Application Form Please Complete In Block Capitals Please fill out the application form below. The information you provide on this form is the only information we will use in deciding whether or not you will be shortlisted for interview. You are therefore strongly advised to complete the application form as fully as possible. If you are filling the form in by hand, please use black ink to enable clear photocopies to be taken. Before you proceed, we would like to take the opportunity to thank you for expressing an interest in working at YESSS Electrical. We wish you every success in your application for employment. 1. Role Information Position Applied For: Location: Job Reference: Department: Closing Date: Where Did You Hear About This Vacancy? 2. Personal Details Please complete this section in BLOCK CAPITALS and ensure the information provided is accurate. It is the only way we have to get in touch with you. Title: (please tick appropriate box) Dr Mr Mrs Miss Ms Other (please specify) Forename(s): Surname: Known As: UK National Insurance Number: Current Address: Postcode: Address: Home Telephone: Mobile Telephone: Work Telephone: Preferred Method Of Contact:

2 3. Qualifications Education & Professional Qualifications: Include in this section all of your relevant qualifications, starting with the most recent. Please also indicate the subjects you are currently studying. Continue on a separate sheet if necessary. Subject / Qualification: Place of Study: Grade / Result: Year Obtained: Training Courses Attended: Include in this section any relevant training courses that you have attended/are currently undertaking, starting with the most recent. Continue on a separate sheet if necessary. Course Title: Training Provider: Duration: Year Obtained: Membership of Professional Bodies: List in this section any relevant professional registration or memberships. Continue on a separate sheet if necessary. Professional Body: Membership Type: Membership Number: 4. Employment History Please record below the details of your current and previous employment, starting with the most recent. Continue on a separate sheet if necessary. Employer Name: Address: Responsibilities: Salary: From To: Notice Period: (If applicable) Reason For Leaving:

3 4. Employment History continued Please record below the details of your current and previous employment, starting with the most recent. Continue on a separate sheet if necessary. Employer Name: Address: Responsibilities: Salary: From To: Notice Period: (If applicable) Reason For Leaving: Employer Name: Address: Responsibilities: Salary: From To: Notice Period: (If applicable) Reason For Leaving: 5. Supporting Information In this section you are required to give your reasons for applying for this position, along with any additional information which demonstrates your suitability for the role. This can include relevant skills, knowledge, experience, training, voluntary work, hobbies and interests, etc. Continue on a separate sheet if necessary.

4 5. Supporting Information continued In this section you are required to give your reasons for applying for this position, along with any additional information which demonstrates your suitability for the role. This can include relevant skills, knowledge, experience, training, voluntary work, hobbies and interests, etc. Continue on a separate sheet if necessary.

5 6. References In this section you are required to provide contact information for two referees. One of your referees must be your present/most recent employer or, if this is your first job after leaving full time education, one of your academic tutors. Details provided in this section are for HR office use only and will not be made available to the shortlisting panel. Referee 1: Title: (please tick appropriate box) Dr Mr Mrs Miss Ms Other (please specify) Full Name: Company Name: Company Address: Postcode: Telephone Number: Address: Relationship: If You Are Shortlisted, Can We Approach This Person Before Your Interview? (please tick appropriate box) Yes No Referee 2: Title: (please tick appropriate box) Dr Mr Mrs Miss Ms Other (please specify) Full Name: Company Name: Company Address: Postcode: Telephone Number: Address: Relationship: If You Are Shortlisted, Can We Approach This Person Before Your Interview? (please tick appropriate box) Yes No 7. Equalities Monitoring Information At YESSS Electrical we are an equal opportunities employer. We would therefore be grateful if you could complete the below information. With the exception of whether or not you declare yourself to have a disability, all information provided in this section is for HR office use only and will not be made available to the shortlisting panel. Special arrangements can be put in place to support shortlisted disabled candidates through the interview process. Full Name: Gender: (please tick appropriate box) Male Female Date of Birth: Age: place of birth: Natonality: Disability: The Disability Discrimination Act says that you may be disabled if you have a substantial physical or mental impairment that affects your ability to carry out day to day activities and which has lasted, or is likely to last, for more than 12 months. Do you consider yourself to have a disability? Yes No Prefer not to say If you have answered yes to the above question, please state the nature of your disability and any reasonable provisions we can make to support you through the interview process.

6 7. Equalities Monitoring Information continued Race / Ethnicity: (Please tick the box below that best describes your racial / ethnic origin) White: British Irish Other (please specify) Asian or British Asian: Bangladeshi Indian Pakistani Other (please specify) Chinese and Other Ethnic Group: Chinese Other (please specify) Black or Black British: Caribbean African Other (please specify) Mixed: Asian and White Black African and White Black Caribbean and White Other (please specify) Prefer not to say Religious Beliefs: (Please tick the box below that best describes your religion/belief) None Buddhist Christian Hindu Muslim Sikh prefer not to say Other (please specify) Marital Status: (Please tick the box below that best describes your marital status) Married / Civil Partner Divorced Single Widowed prefer not to say Other (please specify) Sexual orientation: (Please tick the box below that best describes your marital status) Hetrosexual / Straight Gay Lesbian Bisexual prefer not to say Other (please specify) 8. Criminal Convictions (The Rehabilitation of Offenders Act, 1974) The Rehabilitation of Offenders Act (1974) helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the Court has elapsed and the convictions become spent. During the rehabilitation period, convictions are referred to as unspent convictions and must be declared to employers. At YESSS Electrical we do not discriminate unfairly against applicants on the basis of a criminal conviction or other information declared. With the above information in mind, please complete the below information. Failure to declare any unspent convictions currently on your record may render you liable to summary dismissal. Information provided in this section is for HR office use only and will not be made available to the shortlisting panel. Have you been convicted of a criminal offence which is not spent under the Rehabilitation of Offenders Act 1974? Yes No If you have answered yes to the above question, please provide details. Continue on a separate sheet if necessary.

7 9. Driving Licence Details Only complete this section if it is applicable to the position you are applying for (e.g., van driver). Information provided in this section is for HR office use only and will not be made available to the shortlisting panel. Licence Type: Full UK Driving Licence: Yes No LGV Licence: Yes No FLT licence: Yes No Licence Number: Licence Number: Licence Number: Expiry Date: Expiry Date: Expiry Date: Endorsements Do you have any endorsements? Yes No If you have answered yes to the above question, please specify below the date/s, offence/s and offence code/s. Continue on a separate sheet if necessary. 10. Declaration & Submission Please read the declaration below and sign and date to confirm that the information that you have supplied is complete and truthful, and that you agree to the information being processed and used by YESSS Electrical for the purposes of recruitment, monitoring and (if appropriate) subsequent employment. if you are completing the form online typing your name will suffice. By supplying the information on this form you consent to it being processed for all employment purposes as defined in Data Protection legislation and its use in any verification checks that may be made. I certify that, to the best of my knowledge, all of the information I have given is correct. I understand that by deliberately giving false or incomplete answers I will be disqualified from consideration for this post or, in the event of my appointment, may be dismissed without notice. I also understand that the appointment will be subject to satisfactory reference checks and eligibility to work in the UK. Signature of Applicant: date: Again, thank you for expressing an interest in working at YESSS Electrical and for taking time to complete the application form. Unless otherwise stated in the advert, please return your completed form before the closing date stated on the advert to one of the following addresses: Postal address: Human Resources Department, YESSS Electrical, Yesss house, Foxbridge Way, Normanton, West Yorkshire WF6 1TN address: If you are shortlisted for interview, you will receive confirmation within four weeks of the closing date. If you do not hear anything after four weeks of this date, you should presume that your application has been unsuccessful and will not be progressed further. Good luck with your application. Yours faithfully, HR Department YES-0587-RS

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