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SSR Personnel Application form
Private and Confidential,
Please complete as much of this information as possible
Personal Details
_____________________________________________________________________________________________________
Title
First Names
Surname
Tel No: (Home)
Tel No: (Work)
Mobile
N.I. number
Present Address
Country
Post/Zip code
Email
Are
you prepared to move to another location
If yes, state preferred location(s)
Yes
No
Would you consider contract work?
Are you subject to Immigration Control?
Yes
No
Yes
No
If yes, do you have a unrestricted entitlement to take up employment in the UK? Yes
No
What is your notice period?
Date of Birth
(dd/mm/yyyy)
Country of Birth
Please indicate the regions you are currently entitled to undertake paid employment (tick all that apply)
E EC
USA
Asia
S. America
Russia & CIS
China
____________________________________________________________________________________________________
Employment Record
If this includes a period of self-employment, please give two referees i.e. bank/customer/supplier etc.
_____________________________________________________________________________________________________
Name of current or last Employer
Tel No
Fax:
Country
Full address
Post/Zip code
Position Held
Reporting to
From
To
Description of Company
Basic salary
Benefits
Description of your duties/responsibilities
____________________________________________________________________________________________________
Previous Employer
Tel No:
Fax:
Position Held
Reporting to
Full address
Country
Post/Zip code
____________________________________________________________________________________________________
Previous Employer
Tel No:
Fax:
Position Held
Reporting to
Full address
Country
Post/Zip code
____________________________________________________________________________________________________
Education
____________________________________________________________________________________________________
Name & Address of establishment
attended
Dates
From
To
Qualifications
Other relevant courses
Membership of Professional Bodies, Training achievements etc
____________________________________________________________________________________________________
Further details
____________________________________________________________________________________________________
Do you hold a current national driving licence?
Yes
No
Do you have your own transport?
Yes
No
Do you have a company car?
Yes
No
Have you or a near relative ever been fined, sentenced to imprisonment or placed on probation for a criminal act (subject to the Rehabilitation of Offenders Act)
Yes
No
Has any order been made against you by a civil or military court or public authority?
Yes
No
____________________________________________________________________________________________________
Personal References
____________________________________________________________________________________________________
Give the names and addresses of two personal referees known to you in excess of 10 years and in what capacity. These should not be relatives or previous employers. School leavers/graduates should name their headmaster/tutor as applicable.
Name & address
Profession
Capacity Known
Name & address
Profession
Capacity Known
I certify that, to the best of my knowledge, the information that I have given is true and complete. I have never been convicted of any civil or criminal offence or dismissed from employment for my misconduct. I understand that any false statement or omission may render me liable to dismissal without notice or prosecution. I accept that I am be required to undergo a medical examination where requested by the Company and I consent to the results of such examination being given to the Company. I understand and agree that if so required I will make a Statutory Declaration in accordance with the provisions of the Statutory Declarations Act 1835, in confirmation of previous employment or unemployment.
I agree with the above statement
Yes
No
Date
(dd
/
mm/yyyy)
This application form must be dated
To send a complete CV, please attach documents as an e_mail and send separately
to
jobsinalarms@ssrgroup.com