Recruitment

Title

Full Name

Address

Town

County

Postcode

Landline

Mobile

Email

Date of Birth

National Insurance Number

Next of Kin Name

Next of Kin Contact Number

Next of Kin Relationship To You

UTR Number

Do you have your own car? Do you have your own car? Yes No

Do You have a clean driving licence? Do You have a clean driving licence? Yes No

Do you have your own equipment and tools? Do you have your own equipment and tools? Yes No

Do you hold a CPCS or CSCS card? Do you hold a CPCS or CSCS card? Yes No

Please specify what equipment you own

Place / town of birth

Nationality

EC National EC National Yes No

Any convictions? Any convictions? Yes No

Please provide further details on any convictions

Starting with your most recent, please detail relevant courses that you have attended

Starting with your most recent, please provide details on your previous employment

Describe briefly the nature of your present appointment

Any other position which you have held that you feel is relevant to mention

Do you suffer from any illness or impediment that will prevent you from doing your job? Do you suffer from any illness or impediment that will prevent you from doing your job? Yes No

Have you ever been dismissed from or refused employment on the grounds of health? Have you ever been dismissed from or refused employment on the grounds of health? Yes No

Please provide further details

Under the Disability Discrimination Act, a disability is defined as a physical or mental impairment which has a substantial and long-term adverse effect on a persons ability to carry out normal day to day activities. Tower Staff Construction welcomes applicants from candidates with disabilities. If you require any adjustments to the interview/selection arrangements, please contact us to discuss your requirements. Do you consider yourself to have a disability? Under the Disability Discrimination Act, a disability is defined as a physical or mental impairment which has a substantial and long-term adverse effect on a persons ability to carry out normal day to day activities. Tower Staff Construction welcomes applicants from candidates with disabilities. If you require any adjustments to the interview/selection arrangements, please contact us to discuss your requirements. Do you consider yourself to have a disability? Yes No

Name

Address

Postcode

Phone number

Email

Can we contact this referee before interview Can we contact this referee before interview Yes No

Name

Address

Postcode

Phone number

Email

Can we contact this referee before interview Can we contact this referee before interview Yes No

Relationship to you

Name

Address

Postcode

Phone number

Email

Can we contact this referee before interview Can we contact this referee before interview Yes No

Relationship to you

Additional comments

Declaration Declaration I hereby certify that the information submitted is correct to the best of my knowledge