Job Application

Personal Information

Position:

Title:

Surname:

Firstname:

Middlename:

Preferred Name:

Nationality:

National Insurance No.:

Full Address:

Postal Code:

Telephone Number:

Mobile No.:

Email Address:

Preferred Contact Time:

Daytime Evening

Work Experience

Organization:

Position:

Date From:

Date To:

Reason for leaving:

Add More

Education/Training

School Name:

Address:

Date From:

Date To:

Qualification/Grade:

Add More

Rehabilitation of Offenders Act 1974 and Criminal Records

By virtue of the Rehabilitation of Offenders Act 1974 (Exemption)(Amendments) Order 1986, the provisions of section 4.2 of the Rehabilitation of Offenders Act 1974 do not apply to any employment which is concerned with the provision of health services, and which is of such a kind to enable the holder to have access to persons in receipt of such services in the course of his/her normal duties. You should therefore list all offences on a separate sheet even if you believe them to be “spent” or “out of date” for some other reason.

Have you ever been convicted of acriminal offence?

Yes No

Have you ever been cautioned or issued with a formal warning for any criminal offence?

Yes No

If you have answered “yes” please attach details, including dates and mitigation on a separate sheet which will be referred to and assessed by our DBS panel.

DBS Info

References

Please give the names of two professional people of a senior grade / position to you, including your present or most recent employer, whom we may approach for a reference (not relatives or friends). They must be able to provide a credible comment on your ability to undertake the duties ofthe post applied for. By signing below and providing the names of two referees you are consenting to ISS sharing your personal details with the referees for them to verify your identity.

Home addresses of referees are not acceptable.

Reference 1

Full Name:

Position:

Company:

Work Address:

Post Code:

Tel No:

Fax No:

Email Address:

How long has this person known you in a professional/work context?

Was this person senior to you?

Reference 2

Full Name:

Position:

Company:

Work Address:

Post Code:

Tel No:

Fax No:

Email Address:

How long has this person known you in a professional/work context?

Was this person senior to you?

Recruitment Privacy Consent Statement

For Pendulum Rise to provide you with work you are required to fill in the application below, by submitting this application you are consenting to the use your personal data provided to us, in relation to the role that you are applying for. You are also consenting us to hold your personal data within our candidate database for reference to future roles with Pendulum Rise, and to contact you regarding any such roles

Any data submitted will be used for recruitment purposes, and any other sales or marketing activities which we feel would be relevant to you. We may share your information, such as personnel and health information with our clients and other third parties, such as government bodies, to provide you with work placements and to allow the monitoring of our compliance to contractual and legislative requirements.

As an applicant who has supplied their personal details you have the right to request, that your personal data be removed from our systems by emailing hr@pendulumrise.com if however,you commence work with the Company,then we retain the right to decline any request to be removed, as we may need to retain your personal data for regulation purposes.

I consent to Pendulum Rise holding and processing my personal data as specified in the statement above