Xbasic Sample
Xbasic Sample
Xbasic Sample
RhrmD/01/2022
Please ensure you complete all sections of this form as regards to instructions
Position applied for
Date of the Registration Ref/Reg Number
Personal Details
Title: Other: Last Name
First Name
Address
, Postcode
Preferred telephone number Email
Are you currently working Yes No
Employment History (Don’t fill this if you haven’t been employed before)
Starting with your most recent job, paid and/or unpaid, please list employment providing
all of the details requested. It is important that you include periods of unemployment;
detailing which office you may have received benefits from, and if you have been self
employed you will need to explain.
If you are short-listed we will obtain references, which may cover a full three-years history,
This could include time spent in education as well as In addition to information on
ability and performance.
Name of Current/Last Employer
Address
Postcode Employer’s telephone number
Job Title
Date from Leaving date or notice period
Reason of leaving
Brief description of responsibilities:
Employment historycont.
Previous Employment
Employer’s/Organisation’s Name
Address Post code
Post held Date from to
Reason for leaving
Employer’s/Organisation’s Name
Address Post code
Post held Date from to
Reason for leaving
Employer’s/Organisation’s Name
Address Post code
Post held Date from to
Reason for leaving
Referees
Pleasegive the details of two referees. One of these should be your Line manager with your
present and/or last Employer/Field Work. Please see guidance notes for more information.
Referees name Post held
Address
Postcode
Professional Qualifications/Training
Please provide details of any Professional Training and qualifications that you hold
Grade/Award
Date Obtained
Disability
The Disability Discrimination Act protects people with disabilities from unlawful discrimination. To
meet the Act’s definition, a person must have a physical or mental impairment, which has substantial
long-term effects on their ability to carry out normal day-to-day activities. If we know you have a
disability we will make adjustments to the working arrangement and/or the working environment
provided it is reasonable in the circumstances to do so.
Do you have a disability you wish us to know about at this stage? Yes No
Please let us know what access requirements you have:
Workforce Monitoring
1. Gender
Male Female Other
Please choose one selection from A to E and then tick the appropriate box within your chosen
section to indicate your cultural background.
A. White
British Irish
Any other White Background
B. Mixed
White and Black Caribbean White and Black African
White and Black Asian Any other Mixed Background
C. Asian or Asian British
Indian Pakistani
Bangladeshi Any other Asian Background
D. Black or Black British
Caribbean African
Any other black background
E. Chinese or other Ethnic Group
Chinese Any other Background
Do you consider that you have a disability as defined by the Disability
Discrimination Act 1995?
This means long term illness, health problem or disability that limits your daily activities or
the work you can do. Yes No
Declaration of Offences
Possession of a conviction or caution will not necessarily mean that you won’t be appointed,
each case is considered on its merits. All information given will be treated in the strictest
confidence and will be used for this job application only.
I certify that, to the best of my knowledge, the information on this form is true and accurate. I
k understand that if the information I have supplied is false or misleading in any way, it will
automatically disqualify me from appointment or may after appointment lead to disciplinary
action, which could lead to my dismissal without notice.
Names
w Signed Date
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Guidance Notes.
How to complete your application
The Registration form plays an essential part in choosing the right person for a job. It is the
information contained in your application and supporting statement that will decide whether
or not you are invited for an interview or to the next stage in the selection process.
Give examples of what you have done which prove your ability. If the person specification says, ‘able to
organize activities’, you must do more than say, ‘I am an organized person’. Give an example by
describing something that you have done, which tells us about the skills you used and the steps that
you took.
You can use examples from your home life, time spent in education, voluntary work or from your
hobbies/interests if you do not have any formal experience.
Declaration
We do not exclude people who are related to, or have a close personal relationship with our Staffs or
Company Directors. We will make sure that theydo not take part in the selection for the posts.
Monitoring
This Recruitment Agency hasan Equal Opportunity in Employment Policy, which we ensure that we
monitor to ensure that our candidates reflect the community we serve. The information provided will
be treated in the strictest confidence, is never available to the recruiting manager and will only be
used for monitoring purposes.
Checklist
Before you submit your application, please check that you have:
.
Read through the Job Description & Person Specification so that youknow exactly what the job entails
and the skills, knowledge, abilities and perhaps qualification required to do the job
Read through your application form and make sure that you have filled out all the parts that we have
asked you to
NB. After you have successful fill your recruitment form, please confirm payment of
20,000/= with respect to Registration Form by following payment instructions
After successful fill registration form, below is the instruction for seminar for all registered
candidates.
Let you know, if you are offered a post, what checks and
clearances will be required before your appointment is
confirmed.
N.B