Alchemy Carta Ltd.
St Mary's Mill,
Unit 43, Faircharm Trading Estate,
Evelyn Drive,
Leicester. LE3 2BU

Telephone : +44 (0)116 282 4824
Email : info@alchemygroup.com
Website : www.alchemygroup.com

APPLICATION FORM

Full name of applicant:

Post applied for :

Date form sent:

THIS FORM SHOULD BE COMPLETED BY THE APPLICANT. THE INFORMATION SUBMITTED WILL BE TREATED IN STRICT CONFIDENCE.

Surname :

Forename(s) :

Address :

Email :

Education

Name(s) of School(s)	Dates	Examinations passed. Results with Grades (or awaiting results)
Further/Higher Education

Secondary Education

PREVIOUS EMPLOYMENT (please specify periods of unemployment)

Full dates of service (most recent first)	Name and address of employer	Position	Salary	Reason for leaving
From
To

From
To

From
To

From
To

References

Application for a reference may be made to any previous employer. Please give below the names of TWO persons, NOT relatives, to whom we may apply. We will not ask your current employer until we have your permission.

Name	Address	Connection

Additional Details

Hobbies and Interests, etc
What are your hobbies and interests? (please give details of any talents or experience)

Please give details of experience/skills you have which you feel are relevant to the position applied for and the reason you have applied for this position.

Do you hold a current clean driving licence? Yes / No

Do you have your own transport? Yes / No

What means of transport would you use to travel to and from work?

Where did you see this position advertised?

I UNDERSTAND THAT IF I ACCEPT AN OFFER OF EMPLOYMENT AND ANY OF THE ABOVE INFORMATION IS SUBSEQUENTLY FOUND TO BE INCORRECT, MY EMPLOYMENT MAY BE TERMINATED FORTHWITH.

Signed:

Date: