APPLICATION FORM Snakes and Ladders

1 Children s Indoor Adventure PlaygroundsSnakesand LaddersCONFIDENTIALAPPLICATION FORMThis form will be photocopied. Please complete clearly in black penPlease select a locationSurnameForename(s) Previous SurnamesDate of Birth Present AddressHome Address (if different) Post CodePost Code Telephone (Home)MobileNational Insurance Number:Are you a European citizen? Yes NoIf Not, do you have a permit to work in the UK?Yes NoPost applied for (Please tick boxes which apply)Full TimePart Time*Playframe AssistantCatering Assistant *If applying for part time employment, please state the details of when you will be able to can work:FromToMondayTuesdayWednesdayThursda yFridaySaturdaySundaySchool HolidaysAbingdon Brentford Dunstable IpswichPresent/most recent post (if applicable)Previous Employment (if applicable)Company name: Company address: Post code: Position held: Description of work done: Reasons for leaving: Final wage/salary.

2 FromToFull/Part-timeName of employerPosition heldDescription of Reason for Final wage /work doneleavingsalaryAll Education and Training (from Secondary)FromToName of school / college /Qualifications / certificatesDate of university / organisationstate subjectsqualificationsPresent/most recent post (if applicable)Please give the names and addresses of two referees, one of whom should be your present/most recent employerplus one other who can vouch for your professional work. If you are applying for your first position, give thenames of your head of school and your personal Name2. NameAddressAddressPost CodePost Code Job TitleJob TitleReference may be made to your present / most recent employer if not quoted may / may not proceed with reference enquiry before my interview.

3 (delete as appropriate)MedicalDo you have any disabilities which could affect this APPLICATION ?YesNoIf yes please give details: Do you suffer from a serious illness or allergy?YesNoIf yes give details: Name and address of doctor: (Your engagement may be subject to you passing a medical examination. You may be required to take a medicalexamination at any time during your employment with the company.)Drivers LicenceDo you have a current driving licence?YesNoDriving Licence No. Expiry date: Group Have you been disqualified from driving or hadyour licence endorsed within the last three years?YesNoIf yes please give details:Have you any friends or relations working for the company?

4 YesNoIf yes please give details: Do you have any record of criminal convictions?YesNoIf yes you are obliged to disclose them. Please attach could you take up your duties if appointed ?I have answered each question to the best of my knowledge and ability and understand that if employed, any deliberate misrepresentation may result in of Offenders Act 1974 (Exceptions Order 1987)Supporting StatementPlease return this form to the Personnel Managerat the applicable address: Snakes & Ladders , Audlett Drive, Abingdon, Oxfordshire OX14 3 NJTel: 01235 522 227 Snakes & Ladders , Syon Park, Brentford, Middlesex TW8 8 JFTel: 020 8847 0946 Snakes & Ladders , Blackburn Rd, Houghton Regis, Dunstable, Beds LU5 5 BQTel: 01582 660 111 Snakes & Ladders , Cavendish Street, Ipswich, Suffolk IP3 8 AXTel.

5 01473 255 000 Please give details of your experience, skills, abilities, and additional information which you think would be usefulin this job. (This may include spare-time activities, unpaid work, voluntary work, etc.) Continue on a separatesheet if you need more space.