Title Page
RS WORLDWIDE LTD Application Form
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Application for:
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Hotel Name:
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Emp no:
Personal Details
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Instructions:
1. Fill out the Employment Application Form below.
2. Make sure to answer all questions in each section.
3. Leave complete notes on questions that require specific details. (E.g Have you ever made a claim on Workers’ Compensation before?)
4. Complete the form by leaving a digital signature.
PERSONAL DETAILS
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TITLE: MR/MRS/MISS/MS
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Surname:
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Forename/s:
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Date of Birth:
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Address:
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POST CODE:
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Proof of address
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E-mail Address:
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Contact Telephone:
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Mobile:
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National Insurance Number:
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National Insurance Number
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Marital Status:(SINGLE/MARRIED/DIVORCED)
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Country of Birth:
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Nationality:
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PASSPORT/VISA/ID.
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Passport Expiry date:
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Id Expiry date:
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Visa Expiry date if Applicable:
Employment History
CRIMINAL CONVICTIONS & OFFENCES EFFECTING
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Subject to the Rehabilitation of offenders Act 1974,<br>have you ever been fined, Imprisoned, placed on probation<br>discharged on payment of costs or had any orders made<br>against you by Criminal, Civil or Military Court?
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Please give details
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Have you ever been declared bankrupt
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Are there any alleged offences outstanding against you?
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Have any County Court Judgements been Issued against you
HEALTH
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Have you ever been diagnosed with any medical conditions
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Have you ever undergone any medical treatment or been<br>prescribed any medication?
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Please state number of days absent from work due to illness<br>in the last 12 months.
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Would you be prepared to undergo medical examination if<br>Required ?
EMPLOYMENT HISTORY 1:
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Name of the Company:
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Manager name:
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Contact Number:
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EMAIL ADDRESS
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START DATE:
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END DATE:
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REASON FOR LEAVING:
EMPLOYMENT HISTORY 2:
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Name of the Company:
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Manager name:
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Contact Number:
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EMAIL ADDRESS
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START DATE:
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END DATE:
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REASON FOR LEAVING:
Emergency contact Name (Next of KIN):
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NAME:
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RELATION:
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PHONE NUMBER:
ETHNIC ORIGIN:
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A:White:British<br>Irish<br>Any other White background (please write in)<br>
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B : Mixed<br>White and Black Caribbean<br>White and Black African<br>White and Asian<br>Any other mixed background (please write in)<br>
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C : Asian or Asian British<br>Indian<br>Pakistani<br>Bangladeshi<br>Any other Asian background (please write in)<br>
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D : Black or Black British<br>Caribbean<br>African<br>Any other Black background (please write in)<br>
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E : Chinese or other ethnic group<br>Chinese<br>Any other (please write in)<br>
ADDITIONAL INFORMATION
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Are you prepared to work on Weekends?
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Are you prepared to work on Public Holidays?
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Are you prepared for Evening work?
BANK DETAILS:
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Bank Name:
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Account holder Name:
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Sort Code:
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Account Number:
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DECLARATION<br>I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate<br>omissions will disqualify me from employment or may render me liable to summary dismissal.<br>I understand these details will be held in confidence by the Company, for the purposes of ongoing personnel administration and<br>payroll administration in compliance with the Data Protection Act 1998. I undertake to notify the Company immediately of any changes<br>to the above details. If there is overpaid to your account, He/ She have to inform the RS Worldwide Ltd as soon as possible as it is<br>your legal obligation; you have to transfer the amount to RS Worldwide Ltd account. Failure to follow this procedure the company has<br>right to take a legal action.
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Add signature
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DATE
Acknowledgement
ACKNOWLEDGEMENT
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I agree that all information prepared in this form is a true and accurate account of my background and experience and that if any information given is false or misleading, that I may be terminated at the sole and absolute discretion of the Company.
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Signature of Applicant
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For Office Use
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Overall Appearance
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Attitude
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Is there CV attached?
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Is there Police Clearance attached?
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Start date
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Other Comments
HM Revenue and Customs
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Last Name:
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First Name(s):
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Home address
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Post code:
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Are you Male or Female:
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Date of Birth:
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National Insurance Number:
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Employment start date:
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Employee statement.
You need to select only one of the
following statements A, B or C -
<br>A - This is my first job since last 6 April and I have<br>not been receiving taxable Jobseeker's Allowance,<br>Employment and Support Allowance, taxable<br>Incapacity Benefit, State or Occupational Pensi
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<br>B - This is now my only job but since last 6 April I<br>have had another job, or received taxable<br>Jobseeker's Allowance, Employment and Support<br>Allowance or taxable Incapacity Benefit. I do not<br>receive a State or Occupational Pension.
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<br>Do you have a Student Loan which is not fully repaid and all of the following apply:<br>• You left a course of UK higher education before last 6 April.<br>• You received your first Student Loan instalment on or after<br>1 September 1998.<br>
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<br>C - As well as my new job, I have another job or<br>receive a State or Occupational Pension.
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<br>Do you have a Student Loan which is not fully repaid and all of the following apply:<br>• You left a course of UK higher education before last 6 April.<br>• You received your first Student Loan instalment on or after<br>1 September 1998.<br>
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Full Name:
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Date:
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Signature:
