APPLICATION FOR EMPLOYMENTA. PERSONAL DETAILS
Title (Mr, Miss, Mrs, Ms)

First Name(s)SurnameNI Number
Passport Type (GB, EU, Non EU)
and Country of Issue

Visa/Work Permit Status
Visa/Work Permit expiry date
Driver’s license (Y/N)
Use of a car (Y/N)

Endorsements (Y/N)
if yes, please provide details

Permanent address
Postcode
Contact number
Mobile number
Email address
Emergency contact (name,number and relationship)1

B. POSITION
Position applied for
Were you referred by a Vision
Engineering employee? If yesplease provide their name

Briefly explain why you
believe you are suited to thisposition
Current salary
Desired salary
Availability/Notice period
Are you available to workovertime (Y/N)
If no please provide details

School/College/University
Further Education

C. EDUCATION & TRAINING
FromTo2

Results/Qualifications

Company name 1

D. PREVIOUS EMPLOYMENT (most recent first)
Position held

Dates worked (from and to)Reason for leaving

Key responsibilities

Company name 2

Position held

Dates worked (from and to)Reason for leaving

Key responsibilities

3

Company name 3

PREVIOUS EMPLOYMENT continued
Position held
Dates worked

Reason for leaving

Company name 4

Position held

Dates worked

Reason for leaving

Company name 5

Position held

Dates worked

Reason for leaving

Explanation for gaps in employment:

E. REFEREES
Please give the details of two referees (one should be your current or most recent employer)
Referee 1 nameCompany
Referee 1 position
Mobile/contact number
Email address
Referee 2 nameCompany
Referee 2 position
Mobile/contact number
Email address4

F. HEALTH DISCLOSURE
Do you have any health problems that might prevent you from performing any
functions of the job applied for? (Y/N)
Do you require any reasonable adjustments to be made to accommodate you in a
potential interview/assessment process? (Y/N)
If yes, please give brief details of the effects of your illness/disability on your day-to-day activities, and any otherinformation that you feel would help us to accommodate your needs during an interview/assessment process
and thus meet our obligations under the Equality Act 2010

G. FINANCIAL DISCLOSURE
Have you ever been declared bankrupt or had civil proceedings taken against you bycreditors? (Y/N)
If yes, please provide full details including County Court Judgements, Individual Voluntary Arrangements

H. CRIMINAL DISCLOSURE
The Rehabilitation of Offenders Act 1974 states that you are not obliged todescribe/disclose details of convictions which are spent under the terms of the Act.
Have you been convicted of any criminal offence(s) which are unspent or are you facing
any criminal prosecution? (Y/N) if yes, please provide full details below

Nature of the offence

Sentence/Court order
Date of conviction

Details of prosecution5

I. DECLARATION & DATA PROTECTION
I declare that the information provided by me to Vision Engineering including in this application form, my CV andqualifications are true and complete to the best of my knowledge and belief. I undertake to notify Vision
Engineering of any material changes to the information I have provided. I understand and agree that
confirmation of my replies to questions on this form will be sought from third party sources and I hereby give
permission for such verifications and for all information provided by me to be processed by Vision Engineering.
Vision Engineering treats all personal data collected during the recruitment process in accordance with allapplicable data protection laws.

__________________________________________
Full name__________________________________________
Signature__________________________________________
Date

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