Please list starting with the most recent, all the organisations for you have worked during the last 20 years: Name(s) and Address(es) Dates Position Held/ Starting/ Reason for of Employer(s) Main Duties Leaving Leaving From To Salary D. HEALTH Are you in good health? YES / NO If No, please give further information: Do you have equipment, support or access requirements relating to health, disability or mental YES / NO health? If Yes, are there any reasonable adjustments which you feel should be made to the recruitment process to support equality of opportunity in your application for this job? Please provide details: Are you prepared to undergo a medical examination prior to employment? YES / NO E. SUPPLEMENTARY INFORMATION Please give details of any experience, skill or achievements that you feel may be relevant in your application for employment. Continue on a separate sheet if necessary. F. PRACTICAL INFORMATION Please describe, with dates, any forthcoming arrangements, events, holidays or other commitments which may impact or limit your attendance or delivery of the job role as described: Are you currently subject to any contractual "restraints of trade" clauses? YES / NO
Please list starting with the most recent, all the organisations for you have worked during the last 20 years: Name(s) and Address(es) of Employer(s) Dates Position Held/ Main Duties Starting/ Leaving Salary Reason for Leaving From To D. HEALTH Are you in good health? If No, please give further information: YES / NO Do you have equipment, support or access requirements relating to health, disability or mental health? If Yes, are there any reasonable adjustments which you feel should be made to the recruitment process to support equality of opportunity in your application for this job? Please provide details: YES / NO Are you prepared to undergo a medical examination prior to employment? YES / NO E. SUPPLEMENTARY INFORMATION Please give details of any experience, skill or achievements that you feel may be relevant in your application for employment. Continue on a separate sheet if necessary. F. PRACTICAL INFORMATION Please describe, with dates, any forthcoming arrangements, events, holidays or other commitments which may impact or limit your attendance or delivery of the job role as described: Are you currently subject to any contractual "restraints of trade" clauses? YES / NO