The Fairlawns at Aldridge Job Application Form
* = Field must be completed.     *Position Applied For:   *Name:   *Address:   NI Number   *Telephone Number:   *Email:   *Wage/Salary Anticipated:         *Why are you interested in this opportunity?   *How do you propose to get to/from Fairlawns?   *What is your current situation?   *Are you applying for a full time or part time opportunity?    Full Time  Part Time If you are applying for a part time job then how many shifts (4 – 6 hours per shift) would you like to work per week?
HOURS WHEN YOU WILL BE AVAILABLE FOR WORK - *PLEASE TICK     07:00 - 12:00 hrs 12:00 - 18:00 hrs 18:00 - 24:00 hrs Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday             PRE –EMPLOYMENT MEDICAL QUESTIONNAIRE In order to ensure that you are able to carry out the job safely and without risk to yourself and others we ask you to provide certain information. This also helps us determine whether we may need to make any reasonable adjustments to assist you in performing the job in accordance with the requirements of the D.D.A. If you have experienced any of the following then please list below:- Circulatory problems, heart problems, respiratory problems, diabetes, epilepsy, skin disorders, recent operations, bone fractures, back trouble, arthritis, rheumatism, injuries joint tendons, eye problems, hearing difficulties, food poisoning, prolonged diarrhoea: *Are you currently on medication? Yes    No *Have you ever made a claim for industrial disease or injury? Yes    No If you have detailed medical problems above then we may ask you to complete a more detailed health declaration, seek your written permission to approach your Doctor or to refer your application and proposed Job Description to the Company Doctors who offer us an Occupational Health Screening Service.
MANY OF THE JOBS AT FAIRLAWNS REQUIRE TEAM MEMBERS TO BE ON DUTY ON SPECIAL DAYS. *ARE YOU PREPARED TO WORK ON THE FOLLOWING DAYS? Bank Holidays Christmas Day New Years Eve Mothering Sunday Boxing Day New Years Day
PLEASE GIVE BRIEF DETAILS OF YOUR LAST THREE JOBS OR ANY WORK EXPERIENCE YOU HAVE UNDERTAKEN: (You may like to attach further information on a separate sheet)           Employer/Job       From       To       Reason for Leaving                 Employer/Job       From       To       Reason for Leaving                 Employer/Job       From       To       Reason for Leaving
Please give details of your education and any examination successes or further training you have received   Please give details of your interests and hobbies   Any further details which may assist us with your application?   Press "Submit" to send your details. * = Field must be completed              All information disclosed will be treated in the strictest confidence and will be used only for the the purposes detailed in the Data protection Act. It is the policy of Fairlawns that there shall be no discrimination in respect of sex, colour, religion, race, ethnic origin or nationality and that equal opportunities shall be given to all applicants and employees.

 

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