Protect Your Home & Transform Your Loft 
 
 
Serving East Anglia, The Home Counties & South East England 

Application Form 

Confidential Application for Employment-F36 
Please fill out the Form below: 

Personal Details 

Education 
Qualifications
Level
Grade
Date
1
2
3
4
Further Qualifications & Training 
Course
Institution
Award gained
Date
1
2
3
Employment History 
Current/Most recent post 
Previous employers 
Employer
Position Held
Pay on Leaving
Start Date
Date Left
Reason for Leaving
1
2
3
4
Experience & Skills 
Please give any further details to support your application. 
What interested you in applying for the position? 
What personal qualities do you think will best help you succeed in this position? 
References 
Please give 2 referees; 1 from employer and 1 personal reference. 
Name
Address
Phone
Employer Reference
Personal Reference
Referees will not be contacted until after an interview has taken place. 
Driving 
Asylum & Immigration 
We are required to check your eligibility for employment in the UK and would therefore ask you to bring your current passport and or alternative right to work documents if you are asked to attend an interview. 
Offences and Convictions 
NB disclosure is not required where there is a conviction to which the provisions of the Rehabilitation of Offenders Act, 1974 apply. Failure to disclose an unspent conviction is, in itself, a criminal offence. If you are unclear please ask the Interviewer. 
Applications Declaration 
 
I understand that the information provided on this application form will remain private and confidential and will be used for the purpose of selection/recruitment. Where the application is successful the organisation may from time to time wish to process this information for personnel administration and business management purposes. Where this is the case processing will take place in accordance with the provisions of the Data Protection Acts 1984 and 1998. By signing this form I am providing the organisation with my consent to all these uses. 
 
I confirm details in this application are correct and complete. I understand that canvassing or giving false information will disqualify my application, or if discovered after appointment may be regarded as grounds for dismissal. 
I also understand that appointment will be subject to satisfactory references and evidence of eligibility to work in the UK. 
EQUAL OPPORTUNITY MONITORING 
 
We are an equal opportunity employer. The aim of our policy is to ensure that no job applicant or employee receives less favourable treatment on the grounds of race, colour, ethnic or national origin, religious belief, political opinion or affiliation, sex, marital status, sexual orientation, gender reassignment, age or disability, or is disadvantaged by conditions or requirements which cannot be shown to be justifiable. 
 
Our selection criteria and procedures are frequently reviewed to ensure that individuals are selected, promoted and treated on the basis of their relevant merits and abilities. 
 
All employees are given equal opportunity and are encouraged to progress within the organisation. 
We are committed to an ongoing programme of action to make this policy fully effective. To ensure that this policy is fully and fairly implemented and monitored, and for no other reason, would you please provide the following information: 
 
I would describe my ethnic group and sex as: (please tick one box for your ethnic group) 
 
 
 
 
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