Application for Employment
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People in Action
White Lion Chambers, 44 High Street,
Bedworth, CV12 8NF

Post applied for......................................................................
Relief..............full/part time.............    (please tick)

Prefered location, (tick all that apply)
Nuneaton.........Bedwoth..........Coventry............Leamington
Spa..........Warwick...........Snitterfield............Gaydon..........

How many hours per week do you require?
..............................................................................

Do you have your own transport?           YES/NO
Do you have a current/full/clean driving license?
                                                                         YES/NO

Date of Birth.........../............./.................

Surname.......................................................................
Forenames...................................................................
Preferred name............................................................
Address.........................................................................
........................................................................................
........................................................................................
...............................................Postcode........................

Tel: (home)...................................................................
Tel: (work)....................................................................

Present/most recent employment
Employer.......................................................................................Job title............................................................................
Date of appointment.......................................Period of notice required....................................................
Summary of present duties and responsibilities:
Previous employment - please list with the most recent first: (continue on a seperate sheet if necessary)

Employers name and address

 

 

 

 

 

 

 

 

 

Support Workers Page

position
dates employed

Reason for leaving