Work For Us GLOW CLEANING SERVICES LONDON Thank you for your interest in joining our team. Please complete our employment application form to begin your application. Application Form Personal Details Education_Employment History References Phone Title * Select Mr. Mrs. Ms. Miss. Surname * Forename(s) * Address * PostCode * Email * Date Of Birth * Sex * Male Female NI Number * Home Telephone No Mobile Phone No * Current valid identification document * Driver’s Licence Passport Other valid government-issued ID Expiry Date * Upload Scan Valid ID (Allowed Types: jpeg, jpg, pdf) * Are there any restrictions on you taking up employment in the UK? * Yes No EDUCATION HISTORY Most Recent Education (School / College / University) Qualification gained * EMPLOYMENT HISTORY Name & Address of Employer * Job Title * Date Joined * Rate Of Pay * Duties * Reason for Leaving * Please note any other employment you would continue with if you are successful in this application. EQUAL OPOPORTUNITY MONITORING I would describe my ethnic group and sex as: White English Scottish Welsh Irish Any other White background Mixed White and Black Caribbean White and Asian White and Black African Any other Mixed background Asian, Asian British, Asian English, Asian Scottish Or Asian Welsh Indian Pakistani Bangladeshi Any Other Asian background Black, Black British, Black English, Black Scottish or Black Welsh Caribbean African Any other Black background Chinese, Chine British, Chinese English, Chinese Scottish, Chines Welsh, or Other Ethnic Group Chines Any other Ethnic background Sex * Male Female Signature(Name) * Date * REFERENCES Please note here the names and address of two persons from whom we may obtain both character and work experience Ref_1 Name: * Ref_1 Address: * Ref_1 Telephone: * Ref_2 Name * Ref_ 2 Address: * Ref_2 Telephone: * Criminal Records (Please note any criminal convictions except those ‘spent’ under the Rehabilitation of Offender Act 1974. If none Employment is dependent upon obtaining a satisfactory Police Check) HEALTH DETAILS Do you have a physical or mental impairment which has a substantial and long term effect on your ability to carry out day to day activities?: * Yes No Please list any diseases, disorders, allergies, muscular or musculoskeletal injuries from which you have suffered or do suffer Please detail any form or medicine, drugs or treatment you are currently and/or regularly receiving DECLARATION (Please read this carefully before signing this application) * I confirm that the information provided above is complete and accurate. I understand that any false or misleading information may give my employer the right to withdraw any offer of employment or terminate my employment. Should the organisation require further information and wish to contact my doctor to obtain a medical report, I understand that the law requires the organisation to inform me of its intention and obtain my consent before doing so. I agree that the organisation reserves the right to require me to undergo a medical examination. I further agree that any such information will be retained in my personnel file during my employment and for up to six years thereafter, and that it will be processed in accordance with the Data Protection Act. I agree that, if successful in this application, I will, if required, apply to Essex Police for a Basic Disclosure. I understand that failure to do so, or if the disclosure is not satisfactory to the company, may result in any offer of employment being withdrawn or my employment being terminated. Signature(Name) * Date *
