THE SWIMMING POOL SAFETY COMPANY LTD

APPLICATION FORM
POSITION APPLIED FOR:

Technical Engineer

The following information will be treated in the strictest confidence.

Personal
(Please complete this section in BLOCK CAPITALS)
Surname:
_____CLARK______________________________
First name:
____________ANDREW_______________________
Address:
__________________________________

_20

ACACIA

ROAD

_____NEW BALDERTON
NEWARK NOTTS
______________________________
Postcode:
_________________________________

__NG24 3AE

Home telephone number:

__________________________

_________01636613703

Mobile telephone number:

___________________________

________07817411298

Full Driving Licence:

Endorsements:

Yes

Yes

If YES, please give further details including dates: _3 POINTS SP30

NOVEMBER 2005____________________________________________________

Are you involved in any activity which might limit your availability to work or your working hours
e.g., local government?
No
If YES, please give full details: ____________________________________________________________________

Are you subject to any restrictions or covenants which might restrict your working activities?
No
If YES, please give full details: ____________________________________________________________________

Are you willing to work overtime, nights and weekends if required?

Yes

Please give details of any hours which you would not wish to work: _______________________________________

Have you any convictions, including both spent and unspent convictions under the Rehabilitation
of Offenders Act 1974? (A copy of the Companys Equal Opportunities Policy and Disclosure and
Disclosure Information Policy is available on request. These reflect the CRB Codes of Practice)
No
If YES, please give full details: ____________________________________________________________________

If offered employment, you will be required to complete a Medical Questionnaire. Are you
prepared to undergo a medical examination before starting employment?
Yes
Have you ever worked for this Company before?

No

If YES, please give full details: ____________________________________________________________________

Have you applied for employment with this business before?

No

Do you need a work permit to take up employment in the U.K.?

No

How much notice are you required to give to your current employer?
WEEK..............

.....1

Education
Schools attended since age 11

From

1981

To

Examinations and Results

1985

O LEVEL HISTORY B
DESIGN C ENG LIT C
ENG LANG B
CSE LEVEL MATHS 4
GEOGRAPHY 1
ENGINEERING 1
PHYSICS 3

ORDSALL
HALL
SECONDARY SCHOOL

College or University

From

To

Courses and Results

Further Formal Training

From

To

Diploma/Qualification

Job related Training Courses

Name of Organisation

Date

BPEC

03/06/2
009
24/01/2
011

FIRE
INDUSTRY 15/03/1
BSASSOCIATION
1&

Subject

ELECTRICAL DEFINED SCOPE

LEVELS
B
&C
DOMESTIC
DWELLINGS
LEVEL A FULL SCOPE FIXED
ELECTRICAL
WORK
IN
DWELLINGS
UNIT 1 FIRE DETECTION DESIGN
UNIT
4
FIRE
DETECTION

Please give details of membership of any technical or professional associations:

______________________________________________________________
______________________________________________________________
______________________________________________________________
Please list languages spoken and the level of competence:

______________________________________________________________

______________________________________________________________
______________________________________________________________
Employment Details
Please give details of your past employment, excluding your present or last employer, stating the
most recent first.
Name and address
of employer
ABC ALARMS LTD

Dates

Position held/Main duties

2008-2011

DIRECTOR/EMPLOYEE
INSTALLING DOMESTIC ALARM
& CCTV SYSTEMS

EEC LTD 28-30

HALL ST
SOUTHPORT

2007-2008

INSTALLER/ENGINEER
OF DOMESTIC ALARMS AND
CCTV SYSTEMS

WENT SELFEMPLOYED
BASIS

BSKYB MIDLANDS
REGION

1998-2007

INSTALLING/SERVICING DIGITAL
SATELLITE SYSTEMS

DIAMOND CABLE
NOTTINGHAM
WALTONS
BUILDINGS
NEWARK
BRITISH COAL
BEVERCOTES
COLLIERY

1995-1998

INSTALLING CABLE TV &

TELEPHONE SYSTEMS
MAKING PREFABRICATED
WOODEN BUILDINGS
UNDERGROUND MINER

CHANGE OF
CAREER
FOR A
MORE
CHALLENGI
NG
TECHNICAL
ROLE
COMPANY
LIQUIDATED

1994-1995
1985-1994

Reason for
leaving
COMPANY
TECHNICALL
Y
INSOLVENT

COLLIERY
CLOSURE

Present or Last Employer

Are you currently employed?

Yes

Name of present or last employer:

_________________________________

__AMBITIONS

Address:
_______________________________

____4
__________NEWARK NOTTS

_________________________
Telephone number:
________01636611320___________________________

PERSONNEL
CARTERGATE

Nature of business:
_____________________________

______AGENCY WORK

Job title & brief description of duties:

________7.5 TONNE
DELIVERING DOMESTIC WHITE GOODS FOR KNOWHOW/CURRYS

DELIVETY

DRIVER

___________________________________
Reason for leaving:
_____
A
PERMANENT
AND
MORE
TECHNICAL POSITION INLINE WITH MY PAST WORKING HISTORY TO FURTHER
DEVELOP MY SKILLS SET
______________________________
Length of service:
PRESENT_____________

From: _____JULY 2011________

To:

Interests, Achievements, and Leisure Activities

(e.g. hobbies, sports, club memberships)

______________________________________________________________
_______DIY,
MOTO-CROSS,
CYCLING
,SOCIALISING
FRIENDS/FAMILY,CINEMA,FOOTBALL KIDS ACTIVITIES/GROUPS
_______________________________________________________

WITH

______________________________________________________________
Supplementary Information
Please set out below any further information to support your application
(e.g. past achievements, future aspirations, personal strengths)

______________________________________________________________
______________________________________________________________
______________________________________________________________
Declaration
I declare that the information given in this form is complete and accurate. I understand that any
false information or deliberate omissions will disqualify me from employment or may render me
liable to summary dismissal.
I understand these details will be held in confidence by the Company, for the purposes of ongoing
personnel administration and payroll administration in compliance with the Data Protection Act
1998. I undertake to notify the Company immediately of any changes to the above details.
Signed:

_____________________________________________________________

PRINTED:
________ANDREW CLARK
_____________________________________________________
Date:
______27/09/2011_______________________________________________________

References
Please give the names of two people (one of which should be your present or most recent
employer) whom we may approach for a reference.
Can we approach your current employer before an offer of employment is made? Yes
Name:JO BOTTON

Name:IAN TAYLOR

Position:

Position:INSTALLATIONS MANAGER

Address:AMBITIONS PERSONNEL

Address:EEC LTD

4 CARTERGATE

28-30 HALL ST SOUTHPORT PR9 0SE

NEWARK NOTTS

ian.taylor@eec-homesecurity.com

Tel. No:01636611320

Tel. No:08003891825

Source of Application
How did you hear of this vacancy?
______________________________

_____JOB CENTRE WEBSITE