Westbridge Furniture Designs Limited APPLICATION FORM by wwr69367

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									                     Westbridge Furniture Designs Limited
                                      APPLICATION FORM
              ALL APPLICATION FORMS MUST BE RETURNED TO THE HR DEPARTMENT AT:
                                          Greenfield Business Park
                                               Bagillt Road
                                                  Holywell
                                                 Flintshire
                                                  CH8 7FF
             Please indicate which site(s) you wish to be considered for by ticking the relevant box(es):

                             Westbridge 1(Deeside Industrial Estate)
                             Westbridge 2 (Greenfield Business Park)

POSITION APPLIED FOR:                               HOW DID YOU HEAR ABOUT US:

SURNAME:                                            TITLE:

FORNAMES:

ADDRESS:




POST CODE:

TELEPHONE: (home)                                   (work)                           (mobile)

MARITAL STATUS:                                     NATIONALITY:

DEPENDANTS:        YES/NO                   IF YES PLEASE GIVE DETAILS:

DO YOU REQUIRE A WORK PERMIT TO WORK IN THE UK? YES/NO

DO YOU HOLD A CURRENT CLEAN DRIVING LICENCE: YES/NO
HAVE YOU EVER BEEN REFUSED A DRIVERS LICENCE BECAUSE OF ILL HEALTH:          YES/NO IF YES PLEASE GIVE
DETAILS:

EDUCATION & TRAINING
SCHOOL OR COLLEGE                           SUBJECTS                                 QUALIFICATIONS




PROFESSIONAL OR OTHER TRAINING:
EMPLOYMENT HISTORY
Please start with your present or most recent employment and work backwards.


COMPANY                             JOB                             REASON FOR LEAVING                 RATE OF PAY
                                    TITLE




PLEASE GIVE DETAILS OF ANY ADDITIONAL INFORMATION WHICH YOU FEEL WILL SUPPORT YOUR APPLICATION
INCLUDING ANY SKILLS OR EXPERIENCE YOU HAVE ACQUIRED THROUGH INTERESTS AND HOBBIES OUTSIDE THE
WORKING ENVIRONMENT:




PLEASE GIVE THE NAMES AND ADDRESSES OF TWO PERSONS AS REFEREES, OTHER THAN YOUR CURRENT
EMPLOYER OR RELATIVES:




NB: No approach will be made to your present employer for a reference before an offer of employment is made to you.


HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENCE?                                          YES/NO
(Declaration subject to the Rehabilitation of Offenders Act 1974)




I confirm that to the best of my knowledge the above information is correct. I understand that if I
am appointed and the information provided is inaccurate, I will be liable to dismissal.



Signature……………………………………………………Date………………………………………………
                                     EQUAL OPPORTUNITIES
Are there any disabilities, which may affect your application?            YES/NO
Please give details:

Are you disabled? YES/NO If yes, are you registered? - Registration No.                           Expiry date

Have you at any time suffered from any of the following health complaints? YES/NO
If yes please give brief details and dates (including isolated or recurring complaints).

Dermatitis/Eczema            YES/NO                              Ulcers (eg gastric/duodenal)      YES/NO

Deafness                     YES/NO                              Ear Infection                     YES/NO

Bronchitis/Asthma            YES/NO                              Chest Trouble                     YES/NO

Rheumatic Fever              YES/NO                              Sclerosis                         YES/NO

Heart Trouble                YES/NO                              Diabetes                          YES/NO

Rheumatism/Arthritis         YES/NO                              Fits (eg epileptic)               YES/NO

Fainting or Giddiness        YES/NO                              Headaches/Migraines               YES/NO

Mental Disorders             YES/NO                              Wrist or hand problems            YES/NO

Back problems                YES/NO                              Smoker                            YES/NO

Kidney problems              YES/NO

Due to the nature of certain work some discomfort may be felt in the hand or wrist. This might be due to
using muscles and tendons in an unusual way. If any pain or discomfort is felt you must inform your
Manager or Supervisor immediately.

Do you wear spectacles or contact lenses at work?                YES/NO
If yes, please specify and give last date of test.

Have you had any serious accidents at work?                      YES/NO           If yes, please give details.




Are you currently taking any prescribed form of medication/drug?                  YES/NO
If yes, please specify.

Date of Birth:




I confirm that to the best of my knowledge the above information is correct.




Signature……………………………………………………Date………………………………………………

								
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