Date From

    Date To

    Name of employer

    Brief details of duties with Position held

    Salary/Hourly Rate




    The information provided on this form will be used as part of our recruitment process to assess your capacity to perform the role which you have applied for.

    Certain information (for example relating to your age, gender, race/ethnic and national origins, disability, sexual orientation, religious or philosophical beliefs) may be used in the statistical format in order that we can assess and report on equality and diversity in our recruitment process but will not be made available to the individual responsible for the recruitment decision.

    If you are successful in your application then the information provided in this form will be kept on your personnel file. If your application is unsuccessful then we will keep this information for a period of 6 months after the recruitment decision has been made.

    For more information on your data protection rights in relation to your application please refer to our Data Protection Privacy Notice – Employee Information, which is available on request or in our Employee Handbook.

    I declare that all information given in this application form is true and complete. I understand that if I have given any misleading information on this form or made any omissions, this will be sufficient grounds for terminating my employment

    All (Sensitive) Personal Data recorded on this form will be used for the purposes of recruitment and employment only and in accordance with the Data Protection Act 2018 and will not be distributed to third parties except with your consent.

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