Application For Employment Form Page 8

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OR ALTERNATIVELY
LIST 2 - COMBINATION B.
Please
Tick
DOCUMENT 1, PLUS ONE FROM THE OTHER TWO
1.
Work Permit or other approval to take employment issued by Work
Permits UK
2.
Passport or other travel document endorsed, showing the holders entitlement
to stay in the United Kingdom and can take the work permit employment in
question.
3.
A Home Office issued letter to the holder confirming that the named person is
entitled to stay in the United Kingdom, and can take the work permit
employment in question.
DECLARATION
(Please read this carefully before signing the application)
I confirm the above information is complete and correct
and any untrue or misleading information will give my employer the right
to terminate any employment contract offered.
I authorise you to contact my doctor for further details
and confirmation of my state of health.
***Choose as appropriate***
I agree to undergo a medical examination if this is required to ensure my suitability to carry
out my duties.
I have given my explicit consent freely.
OR
I agree to undergo a medical examination if this is required to ensure my suitability to carry
out my duties and for provision of medical information as part of an occupational health
scheme or private medical insurance scheme.
I have given my explicit consent freely.
I authorise you to contact the above two stated referees.
Dated :
Signed :

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