Surfbay Leisure Ltd showrooms in Dorset, Devon and Somerset Touring and Holiday Caravans

FUTURE POSITIONS APPLICATION FORM

*STRICTLY CONFIDENTIAL a CV is acceptable only in addition to this completed form
Post Applied For

Title	Forenames	Surname
Address		Date of Birth
		Home Tel
		Work Tel (If we may contact you there)

PRESENT EMPLOYMENT
Post Held
Employer

Date Appointed

Present Pay Rate

Period of Notice Required

PREVIOUS EMPLOYMENT
Dates, From - to	Employer	Post Held	Reason for Leaving

EDUCATION
Name of School/College/University	Examinations Passed	Grade	Date Obtained

PROFESSIONAL / TECHNICAL QUALIFICATIONS
Name of Body/Institute	Qualifications	Grade	Date Obtained

TRAINING
Name of Organisation Providing Training	Course Attended	Date of Course

HOBBIES / RECREATIONAL / OTHER INTERESTS

ADDITIONAL INFORMATION
Please state the nature of your present post and/or details of other positions which you consider relevant to this application. Also provide any other information which might assist us, continuing on a separate sheet if necessary.

PERSONAL INFORMATION
Do you hold a current driving license?	National Insurance Number
Do you have use of a car?
Where did you see this post advertised?
EQUAL OPPORTUNITIES MONITORING INFORMATION
Marital Status How would you describe your marital status?	Ethnic Origin How would you describe your ethnic origin?
Disability Do you consider yourself to be disabled?

Occupational Health Do you suffer from any of the following disabilities or medical conditions?
Breathing Difficulties
Asthma
Bronchitis
Emphysema
Hay Fever

Heart (Cardiac Conditions)
Arrhythmias
Coronary blockages
Any Infarctions
Aortic Aneurisms
Have a pacemaker fitted
Diabetes
Epilepsy
Any Renal problem (Kidneys)

Skin Problems
Dermatitis
Acne
Eczema

Back Problems
Repetitive strain injuries
White Finger Syndrome

Is your eyesight good
Do you ever wear glasses

Do you suffer with any allergies
Are you pregnant
Do you suffer with stress (only if being treated)

Do you require any special personal protective equipment to assist and protect you and your dependants if so please make a note:-

REFEREES & SIGNATURE
Name & Address of FIRST Referee (This should be you present or recent employer) May we contact them without further reference to yourself?	Name & Address of SECOND Referee May we contact them without further reference to yourself?

I certify that statements contained in this application are to the best of my knowledge correct and that knowingly making a false statement may lead to dismissal.
Email address in lieu of a signature	Date

PLEASE NOTE THAT SURF BAY LEISURE OPERATES A NO-SMOKING POLICY ON ALL OF IT'S PREMISES

Click to Send via email or Print Form and return by post to:
Surf Bay Leisure, The Airfield, Winkleigh, Devon EX19 8ZZ

Tel: (01837) 680100
Fax: (01837) 680200