GOODLAUG.COM

JOB APPLICATION (Offerers Wine Cellar Retail Group)
So you want to work in a shop! part time evenings and weekends.
Please fill in this application as we don't just take anyone off the street.

About You

Your Gender
Delete as appropriate
M/F/Other

Your Title
Delete as appropriate
Mr/Mrs/Ms/MD/Ph.D/Sir/Madam

Your First Name(s)

Your Surname

Your Date Of Birth
If you have forgotten your date of birth, please attach birth certificate

Your Sexual Orientation
Please give details of your sexual orientation.

Are you aware of our discrimination and equal opportunities policy?
Please sign here to certify that you have read and understood the policy attached with this application.

Your Address Details


Your Status

Residential Status

Flat - rented accomodation
owner/ocupier
House - rented accomodation
owner occupier
Currently living with parents
I am a resident in an OAP home
Homeless/in sheltered accomodation.


Please provide us with your
home telephone number

mobile telephone number

work telephone number

e-mail address

National Insurance details
Please enter your NI number below.

What employment have you had to date?
please give details of any employers and relevant experience

If none,
Have you applied for a job before?
Yes
No

Have you applied for this job before?
Yes
No

What is your current income?

Are you currently on benefits?
Yes/No

What benefits do you expect to continue to receive if you start work with us?
JSA/Income Support/Invalid Care Allowance/Disability Living Allowance/Other
If Other, please write the name of your current benefit in the box

If you currently in receipt of  Jobseekers Allowance, which Job Centre do you currently sign on at?

If you are not currently in receipt of Jobseekers Allowance, but in receipt of another benefit which Job Centre should you sign on at?

Do you currently have a criminal record?
Yes
No
Yes, but I don't want to disclose it.

Do you hold a driving license?
Yes
Provisional
Currently having lessons but haven't obtained a provisional driving license

Why do you want this job?

Do you have any relevant experience serving or dealing with customers or members of the public?
Yes
No

Do you have any relevant experience of being a customer?
Delete as appropriate.
Yes/No

In order to consider you for employment you must provide us with some references
First reference
What is your relationship to the referee?
Employer/Former Employer/Teacher/Family Friend/Husband or Wife/Mother or Father/Other

If Former Employer, what was the reason for leaving your previous job. Please delete as appropriate
Dismissal/"resignation"/Union Dispute/To Apply For This Job

Second Reference
as above

Please provide as many other references as appropriate.
Please attach extra paper if necessary


Your Health
If you are in any way unhealthy, please answer the following questions to see if you would be suitable for the job?

Have You Ever Suffered From Any Of The Following?

Heart Condition
Epilepsy or fainting attacks
Diabetes
Nervous or Mental Disorder
Depression
High Blood Pressure
Death
Chest Pains
Headaches
Slight Cough
Boredom
Other

If you answered yes to any above, could the condition affect your ability to work?

Have you ever been admitted into hospital for an operation?

Are you on drugs (prescribed)?

Have you ever had an accident at work, or a work-related injury at home?

Equal Opportunities

Which ethnic group would you consider yourself to belong to?

White - British
White - Irish
White - Other
White & Black Carribean
White & Black African
White & Asian
Indian
Pakistani
Bangladeshi
British Asian
Black - African
Black - Carribean
Black - Other
Chinese
Racist

Educational Background & Acheivements

Please provide details any schools/colleges/universities attended, and give details on subjects taken and grades received.
Including dates.

Sign below to declare that the information you have included is accurate to the best of your knowledge, and that you have in no circumstances have you lied on your application.
My Signature                                      Date

If you have got the job our signature will appear below

Work In A Multiplex Bowling Alley

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