11-13 St. Peters Street, Bedford, MK40 2PN Tel: 01234 352343 Fax: 01234 352468 www.bakerbrothersdiamonds.com APPLICATION FOR EMPLOYMENT (All Information treated confidentially) Position Applied For: __________________________________________________________________________________________ Where did you hear about this vacancy: ____________________________________________________________________ Have you applied to Baker Brothers previously? Yes __________ No __________ PERSONAL DETAILS: Title: ________________________________ Surname: ___________________________________________________________ Forenames: ________________________ Maiden Name: _____________________________________________________ Home Address: ________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ _____________________________________________ Postcode: _________________________________________________________ Daytime Telephone: ____________________________________Email: _______________________________________________ GENERAL INFORMATION: Marital Status: ________________________ ______Dependants: (Tick) Yes: _____ No: _____ Ages: _______________ Give details of any serious illness, accident or surgical operation and any other details regarding health: __________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ Number of days absent from work the last year & why: ____________________________________________________ Do you hold a clean driving licence (If no, please give details): ____________________________________________ Have you ever been arrested? (If yes, please give details): _________________________________________________ ___________________________________________________________________________________________________________________ Have you ever been dismissed from a previous job? (If yes, please give details): ________________________ EDUCATION: (Please fill in all details) Secondary Education: Name & Address From To Examinations Level Grade of School Further Education: University/Poly/College From To Examinations Grade Other Courses Attended: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ Professional Qualifications: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ EMPLOYMENT HISTORY: Present/Most Recent Employer: _____________________________________________________________________________ From (Month/Year ) _______________ To Month/Year _______________ Address: ________________________________________________________________________________________________________ ________________________________________________________________ Postcode: _______________________________________ Type of Business: ______________________________________________________________________________________________ Job Title: ________________________________________________________________________________________________________ Major Duties:_________ __________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ Reason for Leaving: ____________________________________________________________________________________________ Period of Notice Required: ____________________________ Salary: _______________________________________________ Please give below details of your previous employment – beginning with the most recent (Use additional sheets if required & account for ALL periods of unemployment). Employer: ______________________________________________________________________________________________________ From (Month/Year ) _______________ To Month/Year _______________ Address: ________________________________________________________________________________________________________ ________________________________________________________________ Postcode: _______________________________________ Type of Business: ______________________________________________________________________________________________ Job Title: ________________________________________________________________________________________________________ Major Duties:_________ __________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ Reason for Leaving: ____________________________________________________________________________________________ Period of Notice Required: ____________________________ Salary: _______________________________________________ KEY WORDS TO DESCRIBE YOURSELF: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ WHAT ATTRIBUTES DO YOU POSSESS THAT YOU THINK MAKES YOU SUITABLE FOR THIS POSITION: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ REFERENCES: Please give the name & details of two people (not former employers or relatives) to whom we may apply for a reference. Full Name: ___________________________________ Telephone: ____________________________________________________ Address: ________________________________________________________________________________________________________ Full Name: ___________________________________ Telephone: ____________________________________________________ Address: ________________________________________________________________________________________________________ EQUAL OPPORTUNITIES: Baker Brothers Jewellers take positive steps to ensure that all persons are selected for a job on their suitability. The information below is for monitoring purposes only and will not be used as part of the recruitment process. Please tick the appropriate box: My ethnic origin/descent is: ____ UK or Irish ____Other European ____Asian ____Caribbean ____Other ANY ADDITIONAL INFORMATION: (Please use additional sheets if necessary). SIGNED: DATE:
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