Application For Employment Form Page 6
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9HEALTH DETAILS
Please list all absences from
work in the past 12 months
and the reasons for such
absences
Do you have any disabilities that might affect your
YES
/
NO
application?
If YES, please tell us if:
a. there are any reasonable adjustments we can make to assist you in your
application
b. there are any reasonable adjustments we can make to the job itself to help you
carry it out
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