Get documents about "APPLICATION FOR EMPLOYMENT
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Application for Employment
(Official use only) (It is essential that this is completed in full. You will find the ref on the covering letter)
Applicant Ref. No. Job Reference:
Full Name: Address:
(Please underline the name you wish to be
called) Postcode:
National Insurance No.
Contact Details
Home Tel__________________________ Work Tel______________________________
Mobile Tel_________________________ Email________________________________
Right to work in the UK (Asylum & Immigration Act 1996)
I can provide confirmation that I am legally entitled to work in the UK YES NO
Details on valid methods of proof can be obtained on:
www.ind.homeoffice.gov.uk/lawandpolicy/preventingillegalworking/codeofpractice/fullcode
Driving licence YES NO
Endorsements
(give full details) YES NO
Membership of any Technical or Professional
Associations
Please state any other qualifications, distinctions or
skills which you feel might be particularly useful for
this job application
Type of School Examination
i.e. Secondary / Grammar / Technical College (Subject & Grade)
Education & Training:
Further & Higher Education:
Please give details of all further education since leaving School, including courses and details of
qualifications.
Type of Establishment Type of Training Subjects Qualifications
i.e. University/College
/Institute
Previous employment (Please start with current or most recent position).
Name, Address Length Type of Job/ Reason for Salary /
of Of
Previous Time with Main Duties Leaving/ Benefits
Employer Previous Wishing
Employer To Leave
If you are successful in your application, will this be your only job? If not, please give details.
Please use this area to demonstrate how you meet the criteria (both essential and desirable) as outlined
in the job advertisement. Failure to complete this section and show that you meet the criteria will
mean you will not be progressed to the next stage in the recruitment process.
Availability:
How much notice are you required to give to leave your present employment?
Please give dates of holidays arranged:
Opt-out agreement (optional)
I ------------------- agree that I may work for more than an average of 48 hours a week.
If I change my mind, I will give my employer (amount of time – up to three months) notice in writing to end
this agreement.
Signed _________________________
Date _________________________
Availability:
How much notice are you required to give your present employer?
PlPl
Please give dates of holidays already booked.
Salary Expectation: ________________
References. Names and addresses of 2 referees we can approach for a confidential assessment of your
suitability for this job, one should be a recent employer or teacher.
NAME ADDRESS AND TELEPHONE OCCUPATION / POSITION
NUMBER
(Please confirm that we may approach any of your past employers for a confidential assessment of
your suitability for employment). YES/NO
(We shall not approach your current employer before an offer of employment, unless you indicate
otherwise).
Declaration
Thank you for taking the time to complete this application form. Please sign the declaration below to
confirm that the information that you have given is correct and complete.
The details given above are correct to the best of my knowledge and belief. I understand that any material
omission or misrepresentation may lead to my employment being terminated. In line with the data Protection
Act, I am happy for this information to be held in a secure place and used in processing my application.
Signed: ___________________________
Date: ___________________________
Please ensure you pay the correct return postage as we cannot be held liable for applications
received after the closing date/time.
Health Questionnaire
At Sangers (N.I.) Ltd we care about our employee’s health & safety and believe that most people will be fit
for employment. For some jobs we need to know about health problems which would place your own or
other people’s health or safety at risk when carrying out certain tasks.
Knowing about any health problems will help us to consider adjustments we can make to your job to reduce
the risk to you or others and forms part of our safety precautions.
Please inform us of any health problems you have by answering the following questions by circling the
appropriate answer next to each question.
Your answers will be treated as confidential and will only be seen by the interviewer and, if further advice is
required, by an occupational health advisor.
1. Do you have a health problem that could be made worse or cause you COMMENTS
difficulties when carrying out the following tasks?
a) Walking or moving around? YES NO
b) Standing for periods of an hour or more? YES NO
c) Lifting, carrying, pushing or pulling laden cages? YES NO
d) Reaching, twisting and turning when stocking shelves or collecting stock? YES NO
e) Bending or kneeling when handling stock at low levels? YES NO
f) Climbing stairs or small step ladders, stand on stools? (kick stools) YES NO
g) Driving a vehicle or holding a driving licence? (e.g Diabetes, epilepsy, fainting attacks) YES NO
h) Concentrating or remembering tasks, instructions or training? YES NO
i) Dealing with supervisors/colleagues in a calm way when under pressure? YES NO
2. Do you have any other disability, health problem or illness that we need to consider if YES NO
placing you in a job?
3. How many days sick absence have you had from work, school or university for health
reasons during the last 5 years (approx.)? If you have had no days sickness in this
time please state zero do not leave blank.
Please give details of periods of absence due to sickness of five days or more.
(Please continue on a separate sheet if required). If you have had no days sickness in
this time please state zero do not leave blank.
4. Have you ever been dismissed from a job because of a health problem made worse by YES NO
your work or which affected your ability to carry out your job?
5. Do you smoke? If “YES”, please give details YES NO
6. Do you drink alcohol? If “YES”, please give details YES NO
7. Are you currently attending hospital or undergoing medical treatment? YES NO
8. Are you on a hospital waiting list for admission? YES NO
9. Do you have a Disability as defined in the Disability Discrimination Act? YES NO
10. Are there any reasonable adjustments that we could make that would enable you to enjoy YES NO
equality of opportunity in our recruitment process or in our employment arrangements?
If you have answered YES to question 8 or 9 please give details (on a separate sheet if
required)
I declare that the foregoing statements are true to the best of my belief, and understand that the results will form the basis
of any offer of employment and understand that falsification could lead to termination of this employment.
I am prepared to undergo a medical examination at the Company’s request, if this is required.
Signature: ................................... Date: .................……...………..
SANGERS NORTHERN IRELAND LIMITED REF NO: (Office use only)
SECURITY SCREENING QUESTIONNAIRE
Please read the instructions carefully. Please complete the questionnaire using BLACK INK. Check that all questions
have been completed where applicable. Should a question on this questionnaire not apply to your particular
circumstances then you must put N/A where appropriate. Remember to complete and sign the declaration.
POLICY STATEMENT
Due to the special circumstances and regulations of the pharmaceutical industry, it is necessary to carry out a security
check on all individuals, in order to maintain the high level of security required within the industry. Sangers is
committed to achieving and maintaining the highest standards of security. It is therefore asked that you complete this
form as honestly and comprehensively as possible. During the selection process you may be required to fill out an
ACCESS (NI) form. This is to verify your identity and any information you may provide in this questionnaire.
Sangers will provide the form and full instructions will be given on how to complete the form and what to do when it
is completed.
CRIMINAL CONVICTIONS
In accordance with Sangers (NI) Ltd terms of employment on security screening you must disclose truthfully and
accurately all matters which may be of relevance.
Do you have any convictions not considered as ‘spent’ under Article 5 of the Rehabilitation of Offers (NI) Order
1978?
Yes No
IF YES PLEASE GIVE DETAILS BELOW
Signature Date
Please note that any information provided would be treated in the strictest confidence. The relevance of criminal
convictions as to your suitability for employment is a matter for Sangers (NI) Ltd to decide. Although it may be taken
into account, any such information will not necessarily prevent you from employment. However failure to disclose
relevant circumstances or information, which may arise at a later time, may in itself be regarded as evidence of
unreliability and may be taken into account when determining your suitability for employment.
Have you ever been charged with an offence whilst serving with the armed forces?
Yes No
PTO
If yes please give details of Charge and punishment awarded
DECLARATION
I declare that I have read and understood the Sangers (NI) Ltd policy on security screening. I understand that as part
of the selection process I may be required to produce an ACCESS (NI) form to my local Police station for verification
of my identity. This will then be used to verify the information I have provided on the ACCESS (NI) form.
I declare that the information that I have given is true and complete to the best of my knowledge and belief.
I undertake to notify any material changes in the information that I have provided to Sangers (NI) Ltd.
I understand that any false statement or deliberate omissions of the information that I have given in this questionnaire
may disqualify me for employment or make me liable to disciplinary action, which may include dismissal and/ or
legal action being taken against me.
Signed. Date.
EQUAL OPPORTUNITIES MONITORING FORM
Summary of Equal Opportunities Policy
Sangers (N.I) Ltd, in respect of its role as an employer, will not discriminate
against any person or group of people on the grounds of sex, marital status, race,
disability, colour, religious belief and / or political opinion, nationality (including
citizenship), ethnic or national origins, family circumstances, gender
reassignment, sexual orientation or age.
Monitoring and Confidentiality
The questions overleaf will help us to monitor the effectiveness of our Equal
Opportunities Policy. The information you supply on this form will be treated
strictly confidential and will be used for statistical monitoring purposes only.
The information will not be seen or used during the selection process. The form
will be separated from your application form as soon as it is received, and
securely stored. Only staff who conduct Equal Opportunities Monitoring will
have access to completed Equal Opportunities Monitoring Forms and the
information contained within.
Data Protection Act 1988
The information you supply is collected and processed in accordance with the Data
Protection Act 1988. Completion of this form is voluntary. When you complete this
form you should sign the declaration to indicate your explicit consent to the
information you provide being processed as follows:
The information is used to provide a statistical breakdown of the background
and circumstances of job applicants, interviewees, and successful candidates.
Completed forms are stored securely for 6 months and are destroyed after this
time
If you are appointed to a post within Sangers (N.I) Ltd, the data you provide
will be held confidentially on a computerised database for the purposes of
ongoing Equal Opportunities monitoring of the workforce.
Only those people directly involved with Equal Opportunities Monitoring will
have access to the information you provide on this form.
Notes
Ethnic Group
The categories we use have been recommended by the Equality Commission and are
the same categories used in the 2001 Census. This means that we can check whether
the profile or our applicants is representative of the national profile.
Disability
The Disability Discrimination Act 1995 defines a disabled person as someone with a
physical or mental impairment that has substantial and long-term adverse effect on his
or her ability to carry out normal day to day activities.
EQUAL OPPORTUNITIES MONITORING FORM
1. Post Applied for: ________________________________________________
2. Name of Applicant: ________________________________________________
3. Gender: Male Female
4. Are you married or in a civil Partnership?
Yes No
5. Date of Birth ____/____/____
6. Do you consider yourself to have a disability? _____________________________
7. Nationality: ______________________________________________________
8. Please indicate your race , colour or ethnic national origins
Bangladeshi Black Other
Pakistani Chinese
Black African Indian
White Irish Traveller
Black Caribbean Any other (please state)
9. Regardless of whether they actually practice a particular religion, most people in
Northern Ireland are perceived to be members of either the Protestant or Roman
Catholic communities. Please indicate the community to which you belong by
ticking the appropriate box below:
I am a member of the Protestant community
I am a member of the Roman Catholic community
I am not a member of either the Protestant or Roman Catholic communities
If you do not answer the above question, we are encouraged to use the residuary method of
making a determination, which means that we can make a determination as to your
community background on the basis of the personal information supplied by you in your
application.
Note: If you answer these questions about community background and gender you are
obliged to do so truthfully as it is a criminal offence under the Fair Employment (Monitoring)
Regulations (NI) 1999 to knowingly give false answers to these questions
