CaNDiDate iNfoRmatioN foRm - Moneycorp

CandidateInformation FormPrivate and confidentialName:Position applied for:Where did you hear about the vacancy?Date:Reference:1984/09/08 01/05

CandidateInformation FormYour personal detailsWe may use the details below to authenticate your identityTitle (Mr/Mrs/Miss/Ms):Middle name:Address:Town/City:Postcode:Town of birth:first name:Last name:County:Country:mother’s maiden name:Contact detailsEmail address:Home telephone number:mobile telephone number:GeneralAre there any restrictions that might affect your right to take up employment in the country for which you are applying? Yes NoIf you are successful in your application, would you require a work permit prior to taking up employment? Yes NoAre you prepared to work: Evenings: Yes No Weekends: Yes No Bank holidays: Yes NoHave you been dismissed from employment within the last five years? Yes No (If yes, please provide details)If you are successful in your application, do you consent to a check being conducted with the Criminal Records Bureau? Yes NoIf you are successful in your application, do you consent to regular credit checks being conducted throughoutyour employment? Yes NoHave you ever been convicted of any offence (except convictions spent under theRehabilitation of Offenders Act 1974 (as amended))? Yes No (If yes, please provide details)Do you have any current or previous County Court Judgments (CCJs) against your name? Yes No (If yes, please provide details)Do you have any current or previous bankruptcy proceedings against your name? Yes No (If yes, please provide details)LanguagesList spoken/written languages indicating level of fluency: (Bilingual, Fluent, Intermediate, Business, Basic)LanguageSpoken levelWritten level1984/09/08 02/05

CandidateInformation FormYour reference details (part one)First name:Maiden name:Last name:any other name used:Are you currently engaged in any additional employment that you would intend to continue if you are successful in your application?Yes No (If yes, please provide details)Please provide details of your employers over the last five years so that we may gain references. This information must be completed infull in order to progress your application.Your most recent or current employerYour job title:Start date:Address:County:Manager’s name:Company name:end date:town/City:Postcode:Manager’s telephone number: M manager’s email address:Name of an HR contact (if known):HR’s telephone number:Your main duties and responsibilities:HR’s email address:Salary and other benefits:Notice period:Reason for leaving:May we approach this employer for a reference prior to offer? Yes NoYour previous employersYour job title upon leaving:Company name:Date employment commenced:Date employment ended:Address:town/City:County:Postcode:Manager’s name:Manager’s telephone number: M manager’s email address:Name of an HR contact (if known):HR’s telephone number:HR’s email address:Reason for leaving:May we approach this employer for a reference prior to offer? Yes No1984/09/08 03/05

CandidateInformation FormYour reference details (part two)Your job title upon leaving:Date employment commenced:Address:County:Manager’s name:Company name:Date employment ended:town/City:Postcode:Manager’s telephone number: M manager’s email address:Name of an HR contact (if known):HR’s telephone number:Reason for leaving:HR’s email address:May we approach this employer for a reference prior to offer? Yes NoYour job title upon leaving:Company name:Date employment commenced:Date employment ended:Address:town/City:County:Postcode:Manager’s name:Manager’s telephone number: M manager’s email address:Name of an HR contact (if known):HR’s telephone number:HR’s email address:Reason for leaving:May we approach this employer for a reference prior to offer? Yes NoYour personal refereesPlease provide the name and address of two personal referees who have known you for at least three years. These referees shouldnot be current work colleagues, related to you or living at the same address as you.First name:Last name:Address:town/City:County:Postcode:Phone number:email address:How long have you known this person?How do you know this person?First name:Address:County:Phone number:How long have you known this person?How do you know this person?Last name:town/City:Postcode:email address:1984/09/08 04/05