Date of employment: (Month/year)
Please give details of any sickness absence during the last two years.
Give names, telephone numbers and e mails of three persons willing to provide confidential reports on request. At least of these should be working with your current or most recent employer (Colleague or Supervisor). References will be taken up upon your selection only.
Weight in Kgs.
By submitting this form, you certify that all the questions have been accurately answered and that you are in possession of the certificates which you purport to hold.
*If short listed for interview, you will be contacted within six weeks. Only short listed candidates will be notified.