Personal Details Surname First Name Title Address       PostCode Telephone Number (Day) Telephone Number (Evening) Telephone Number (Mobile) E-Mail Address Date of Birth Current Driving Licence National Insurance Number Employment Aspirations Type of position sought Why have you applied for a job with Interfleet? Where did you hear about the job? Press Advertisement (please state which) Employment Agency College / School Personal Application Job Fair / Careers Convention From an Interfleet employee (please give name) Interfleet Web Site Other (please specify) Education Secondary Education: School Dates Examinations Passed (subject, grade, etc.) Higher Education: College/University Dates Type of Degree and Grade Principal Subject Details of scholarships, exhibitions, sponsorships, prizes awarded, etc. Please give details of any other skills, qualifications or experience which you feel may be relevant. Employment History Employer Dates Position Held Main Activities / Responsibilities Reason for Leaving Employer Dates Position Held Main Activities / Responsibilities Reason for Leaving Employer Dates Position Held Main Activities / Responsibilities Reason for Leaving Referees Please give the names and addresses of two referees, one of whom should be your most recent employer. Please indicate whether you have any objection to Interfleet contacting them. Yes No Referee 1 Name Address Referee 2 Name Address Equal Opportunities Interfleet Technology is an equal opportunities employer. In order to monitor our recruitment practices and to ensure equality of opportunity, please complete the following sections. Information given will not form part of the selection process. Plese indicate your ethnic origin: Black/Caribbean Black/African Asian White/European Other (please specify) Gender: Male Female Do you consider yourself to have a disability? Yes No If YES do you require any additional facilities or help during the interview/recruitment process? Offences Please give details of any court or court-martial conviction, driving licence endorsement, outstanding summons or prosecution (except spent convictions under the Rehabilitation of Offenders Act 1974). Any false statement will disqualify you from employment or, if discovered after employment commenced, render you liable to instant dismissal. Date Nature of Offence Sentence or Court Order with Costs Data Protection Act The information requested in this application form is used solely for entry onto our personnel database and for equal opportunities monitoring purposes. This information will not be forwarded to a third party without your written consent.