Application Form for Driving Position - PowerPoint by adn10359


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									                                                                                   Q.A.P. 12/A Rev 4
                         FM ENVIRONMENTAL LTD
                          PUMPING & WASTEWATER                           Page :         1 of 4
                           TREATMENT ENGINEERS
                      GREENBANK IND. ESTATE, NEWRY, BT34 2PB
                                                                          Job Ref No:

       CONFIDENTIAL                       Position Applied For :
          Please complete in BLOCK LETTERS using Black Ink
 1.     Personal Details :

 Mr       Mrs     Miss        Forenames                                  Surname


 Email                                             Telephone Number

 Have you suffered from Serious Illness ?                          Yes      No

 Details :

 Have you suffered from dermatitis or any other skin disease ?      Yes      No

 Details :

 Have you experienced any hearing difficulties or deafness ?        Yes      No

 Are you registered Disabled ?                                      Yes      No

 Have you a clean current Driving Licence ?                        Yes       No

 Have you ever been convicted of a criminal offence ?              Yes       No

2.    Education and Qualifications

      Please give details :

 Year                    Examination                                  Subject                    Grade
3.   Employment History                                                          Page :    2 of 4
Please give details of all posts you have held since you completed full-time education.

Start with your present / most recent post.
     Dates           Name and Address              Nature of                Position      Duties
From        To            of Employer              Business

Reasons for leaving/present employer ?

Earnings (per anum) last/present employer ?

4.   Are you a member of any Professional Bodies?               Yes    No
If yes give details:

4a. Are you a member of any Trade Unions?                      Yes    No
If yes give details:

5.   Hobbies/Interests
6.   Additional Information                                                         Page :       3 of 4
Please give details of experience and training relevant to this application :

Have you previously applied for a position or been employed with this organisation ?     Yes    No
Details :

Period of Notice required ?


Please give the names and addresses of two persons who have agreed to act as referees and who have
known you for at least two years. At least one referee should have detailed knowledge of your career to
date and neither should be a relative.

1.                                                     2.


 I hereby declare that the information given in this application is, to the best of my
 knowledge, true and correct. I also agree that any misrepresentation by me will lead to
 the withdrawal of any offer of employment being terminated without any obligation or
 liability to the Company other than for any services rendered.

 Signature :                                                                    Date :
                                Return to : PERSONNEL DEPARTMENT
Office Use                                   Page :   4 of 4

     1.             2.             3.   4.   5.       6.

Comments :

Copies of Certificates Received:

 F.E.C Documentation:

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