Personal Details

    Title:

    Full Name:

    Your Consultant:

    Address:

    Post Code:

    Home Phone Number:

    Mobile Phone Number:

    Email Address:

    Residential Status:

    Licence Expiry:

    Where did you hear about us?

    Please tick all that apply: Google (or other search engine)FacebookLinkedInInstagramRecommendation/word of mouthOther, please specify

    Work Type and Pay Details

    Type of role sought:
    Notice Period/Availability:
    Minimum Salary / Pay Rate:
    Current Salary:
    Current Benefits:
    Study Fees Owed:
    Would you consider working in another jurisdiction, if so, where?:

    Criminal Convictions/Police Disclosure

    The Rehabilitation of Offenders Act 1974 ("the Act") states that you are not obliged to describe/disclose details of convictions which are considered to be spent under the terms of the act.
    Have you been convicted of any criminal offence(s) which is not yet 'spent' under "the Act" or are you facing any criminal prosecution? (Please do not include fixed penalty driving offences).
    YesNo
    If yes, please provide details:
    The sentence of Court Order:
    The date of the conviction:
    It is the responsibility of the applicant to inform Alexander Daniels Channel Islands Limited when a previously declared conviction becomes spent.
    Do you have a current Basic Police Disclosure? YesNo
    If yes, date of issue:

    Financial Information

    Have you ever been declared bankrupt or had civil proceedings taken against you by creditors? NoYes
    If yes, please give full details, including County Court Judgements, Individual Voluntary Arrangements (IVA)

    Referees

    Please supply names, addresses and telephone numbers of two referees, which should be your last two employers. Contact will not be made without prior permission

    Referee #1

    Contact Name:
    Position:
    Company Name:
    Post Code:
    Employment Dates:
    Position Held:
    Telephone Number:
    Email Address:

    Referee #2

    Contact Name:
    Position:
    Company Name:
    Post Code:
    Employment Dates:
    Position Held:
    Telephone Number:
    Email Address:

    Equality

    Do you consider yourself to have a health condition or disability? NoYes
    If yes, please provide details:

    Declaration

    Please check this form carefully and then sign the below


    I declare that the information given herein in conjunction with my CV and any copy authorisations and copy qualifications are true and complete to the best of my knowledge and belief. I undertake to notify Alexander Daniels Limited to any material changes to the information I have provided. I have read and agree to the Alexander Daniels Limited standard Conditions for recruitment services and the Alexander Daniels Channel Islands Limited privacy policy.
    Your Full Name:
    Today's Date: