Confidential industrial application form assignment

Return completed applications to[email protected]Co. UK Application for the role of: Date of Application Candidate Number (Office use only) Personal Title: First name(s): Last name: Address: Post Code: Home Telephone: Mobile: Textron: Email: Work We may need to contact you during office hours (with discretion) National Insurance Number: Do you have any friends or relatives who work for First Response Recruitment Limited?

Please specify; Date of Birth: Emergency contact (Please give details of a family member or friend who we can contact if necessary) Education, qualifications and training Include qualifications obtained and any other training courses attended. Dates Professional Qualifications held Please give details (if applicable) Employment history Current or most recent employment first Please note; We need a minimum of 26 weeks employment history, Fill out a section for all periods of no work.

If you have been working for an Employment Agency you need to complete a section for each contract you have worked on for the agency. Start Date Finish Date Employment Status Permanent Temp Through Gag Temp with Company Contract No Work (provide Reason) Sick Jury Service Maternity Leave Other (please Sate) Company Name Company Address Contact Name Telephone Agency Name Agency Address Position Brief Summary of Duties Salary / Rate & Benefits Reason For Leaving Please ask for additional forms if required.

I hereby confirm the employment details provided is a true and accurate reflection of my employment history to date. Signed Interviewer Initials (Please do not sign this now, we will run through your history with you first during your interview) References: First Response Recruitment Limited will not offer you any work at all, unless we can obtain two years worth of references, these will be taken prior to any work or role been offered, for temporary workers only. References (2) years worth is required, you must complete this section Please give details of two referees who are able to comment on your work ability.

One referee should be your current or most recent, employer. References must cover the last two years of employment and must not be provided by a family member or relative. You will not be offered ANY role or assignment without these references being on file. Name: Employer’s name and address: Postcode: Relationship of Referee to you: We need to obtain the reference prior to you working for us If you cannot complete this section, you need to advise the Consultant or the Administrator.

We will have no option but to cancel the application if you cannot provide information that is vital to our quality checks and screening process. Disability Discrimination Act 1995 (DAD) & Amended Act 2005 First Response Recruitment Limited has a policy of interviewing applicants who have a disability and who meet the essential short listing criteria. The DAD 1995 & 2005 defines disability as a “ physical or mental impairment that has a substantial and Eng-term adverse effect on the ability to carry out normal day to day activities”.

Do you consider yourself to have a disability, in accordance with the Act? Yes No Do you require any special arrangements if asked to go for an interview. We want to ensure you receive a fair interview, for example; a sign language interpreter, lip-reads, speech-to-text operator, audio transcription, wheelchair-accessible interview room etc… Would you require any reasonable adjustments to be made if you were offered a position with First Response Recruitment Limited clients? Yes No If yes, please describe briefly what these adjustments would be: