Allergy Employment Application

Document Sample
Allergy Employment Application Powered By Docstoc
					Application for Employment Form

Please use BLOCK CAPITALS
Surname:                                                         Forename(s):

Address:                                                         Contact numbers:
                                                                 Home:
                                                                 Work:
                                                                 Mobile:

Postcode:                                                        Nationality:
                                                                 Do you require a permit to work? YES/NO
                                                                 If YES please state number:




Position applied for:




How did you learn of this vacancy?




Please state why you wish to be considered for
this position:




Minimum salary required:                                         Full/Part time:                 Hours preferred:




 Allergy Therapeutics plc., Dominion Way, Worthing, West Sussex, BN14 8SA. Tel: +44 (0)1903 844728 Fax: +44 (0)1903 844743
                               www.allergytherapeutics.com infoservices@allergytherapeutics.co.uk
                                                                                                                  Page 1 of 4
Education details:
Please give details of all secondary and further education, including details of courses and
examinations taken (with results).
Name and address of school/college:                     Qualifications:
                                                        (including apprenticeships, exams with results)




Please state any achievements during your education:




References:
Please give the names and addresses of two people (not relatives) to whom we may write to for
references, at least one of which should be a recent employer or school-based.
1. Name:                                                         2. Name:

   Position held:                                                   Position held:

   Company:                                                         Company:

   Address:                                                         Address:




   Telephone:                                                       Telephone:


Please note that we will NOT contact your present employer for a reference without your
permission. However, any job offer made will be subject to receipt of satisfactory references.

 Allergy Therapeutics plc., Dominion Way, Worthing, West Sussex, BN14 8SA. Tel: +44 (0)1903 844728 Fax: +44 (0)1903 844743
                               www.allergytherapeutics.com infoservices@allergytherapeutics.co.uk
                                                                                                                  Page 2 of 4
Employment history:
Please give details of your previous employment (include part-time, temporary work and periods
that you were not employed), covering the time since you left full-time education or the last ten
years (whichever is greater) starting with the most recent employment and working backwards.
Present or last employer company name:
Position(s) held:                       Salary:                  Outline of duties:




Previous employer company name:
Position(s) held:                       Salary:                  Outline of duties:




Previous employer company name:
Position(s) held:                       Salary:                  Outline of duties:




Please continue on a separate sheet if required


Please provide examples of how you believe your skills match the requirements of the role you
are applying for:




 Allergy Therapeutics plc., Dominion Way, Worthing, West Sussex, BN14 8SA. Tel: +44 (0)1903 844728 Fax: +44 (0)1903 844743
                               www.allergytherapeutics.com infoservices@allergytherapeutics.co.uk
                                                                                                                  Page 3 of 4
Holidays/Courses booked:
Please give details/dates of any holidays and/or training courses you have already booked or are
currently studying.




Other:
Please add any additional information or comments you think will be helpful in your application.




The Data Protection Act 1998
Information provided by you on this application form may be copied for use during the recruitment
procedure. Once the recruitment procedure is completed the data will be stored for at least six
months and then destroyed. If you are the successful candidate relevant information may be taken
from this form and used as part of your personal record.

Undertaking
Please read and sign the following undertaking:

I confirm that the entries I have made on this application form are, to the best of my knowledge
and belief, true in all aspects and I consent to the use of this information during the recruitment
process. I understand that should I have deliberately made a false statement on this application
form, my future employment by Allergy Therapeutics (UK) Ltd could be jeopardised or even
terminated.
Signed:                                                                       Dated:




Thank you for completing this application form; please return to the address at the foot of this
sheet for the attention of the HR Department.


                                              FOR OFFICE USE ONLY:
Date received:




Allergy Therapeutics plc., Dominion Way, Worthing, West Sussex, BN14 8SA. Tel: +44 (0)1903 844728 Fax: +44 (0)1903 844743
                              www.allergytherapeutics.com infoservices@allergytherapeutics.co.uk
                                                                                                                 Page 4 of 4

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:6
posted:12/9/2010
language:English
pages:4
Description: Allergy Employment Application document sample