Perrygrove Railway Job Application Form (Page 2 of 3) in pdf

PREVIOUS EMPLOYMENTS

Please give details of your career history. We have given space for 3 employments – if you wish to provide additional

information please use a separate sheet of paper

Name of employer:

Job title:

Work carried out:

Employment commenced:

ended:

Final pay:

Reason for leaving:

Name of employer:

Job title:

Work carried out:

Employment commenced:

ended:

Final pay:

Reason for leaving:

Name of employer:

Job title:

Work carried out:

Employment commenced:

ended:

Final pay:

Reason for leaving:

PERSONAL DETAILS

Are you: Living Singly [ ] or Married [ ] or with permanent partner [ ] (tick one)

Children (if any please state ages)

Are you receiving any Tax Credits (eg: working family tax credit)?

Have you been convicted of any criminal offence not yet spent under the Rehabilitation of Offenders Act 1974?

Do you object to having an Enhanced Criminal Record Bureau (“CRB”) check carried out, or an application made under

the Vetting and Barring scheme?

I object/do not object/already have* an Enhanced CRB check

I object/do not object/am already registered* under the Vetting and Barring scheme

Please give details of any illness during the last 5 years sufficient to cause absence from work for more than 5 days?

For safety critical work please complete the attached medical declaration form and also answer this question:

Can you distinguish between red and green colours?

Are you able to safely lift a weight of 25 kilogrammes?

Please give details of any disabilities you have which might require your employer to make adjustments to the workplace

If the nature of any disability will require reasonable adjustments to your working environment please state what you

believe these are likely to be (you may leave this section blank until you have seen the workplace if you wish)

Sports, hobbies and interests

Perrygrove Railway Job Application Form Page 2