Employment Application form

Position applied for

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Contact Information

Previous names (if any)

Medical and Equal Opportunities

Under the Equality Act employers have an obligation to make reasonable adjustments to accommodate disabled people. We are an equal opportunity employer and in order to enable us to comply with our obligations under the Act, please provide us with the following information

Do you have any medical condition which might affect your ability to partake in an interview?

If so, are there any adjustments that we could make to enable you to partake in an interview?

Please note that any successful candidates who are offered employment conditionally or unconditionally may be asked to complete a more detailed Medical Questionnaire (whether in relation to any disability or generally in relation to health-related issues) prior to commencing employment.

Education and Qualifications

This information is included within my CV

From GCSE or equivalent to degree level in chronological order

Postgraduate education or study or any other professional qualifications

This information is included within my CV

Do you have any other training, qualifications or skills relevant to the post? If so, please give details

Do you hold a full driving licence? If yes, do you have any current endorsements?

This information is included within my CV


Please give detail s of your last three jobs, beginning with your present or most recent. Any relevant posts held before then may also be mentioned.

From To Name, Address of employer Job title, description of duties, responsibilities, reason for leaving andsalary on leaving

If relevent; please give details of, and provide an explanation for, any time when you were not either working or in full-time education

How many weeks’ or months’ notice are you required to give your current employer?
This information is included within my CV


Please give details of two referees, one of whom should be your current or most recent employer or, if not applicable then a school teacher or higher or further education lecturer. The other should not be a relative or contemporary. By providing the contact details of these referees and signing this form you are hereby giving Hilltop the authorisation to contact these people/companies in relation to your application of work at Hilltop.

Name Organisation Address Telephone/Email Address

Safe Guarding

Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1976 (as amended in 2013*)? If yes, please provide details

*The amendments to the (Exceptions) Order 1976 provide that certain spent convictions and cautions are “protected” and are not subject to disclosure to employers and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.

Do you know of any reason why you should not be put in a position of trust and responsibility of children or vulnerable adults?

I can not be placed in such a position
I can be placed in such a position

Have you made a previous application to the Company or have you previously worked for the Company? Please give details

Please use this space to say why you are interested in this position and provide any other information that may assist your application


I declare that I have the right to take up employment with in the UK and that the information I have given in this form is, to the best of my knowledge, true and complete.
I understand that if it is subsequently discovered any statement is false or misleading, or that I have withheld relevant information, my application may be disqualified or, if I have already been appointed, I may be dismissed.
I hereby give my consent to the Company processing the data supplied on this application form for the purpose of recruitment and selection.

Sign and Submit