APPLICATION FORM
PRIVATE AND CONFIDENTIAL
APPLICANTS MUST BE AGED 18 AND ABOVE As an employee of Xtra-vision you will have a very important role to play in ensuring the success of your store through satisfying the many customers who will require your assistance. To help you to achieve this objective and in keeping with our core value of DEVELOPMENT AND LEARNING we will train you to do your job and give you the opportunity to use your skills and talents. This is your opportunity to tell us as much as possible about yourself. It will help us to make a fair decision to select the people who can naturally give outstanding customer service. Please read the form thoroughly, then complete it carefully, in your own handwriting. SOME GUIDELINES TO HELP YOU
(Please tick boxes as appropriate)
ABOUT YOU
Please complete the following details clearly in BLOCK CAPITALS Surname
Previous Address 1
(If less than 5 years at present address)
First Name(s)
Present Address Phone No.
Post Code
Previous Address 2
(If less than 5 years at present address)
Post Code
Post Code
PPS (PRSI) No.
Are you aged 18 or above?
Have you previously worked for Xtra-vision?
If 'Yes' which store(s) Dates: From
Yes J
Yes J
To
Are there any legal restrictions on you working in Ireland?
No J
No J
Reason for Leaving
J Store Manager (approx. 39 hours per week)
POSITION APPLIED FOR
J Customer Service Representative Full-time (approx. 35 hours per week)
J Customer Service Representative Part-time (hours by agreement) Please state your preferred store location(s) HOURS YOU ARE AVAILABLE TO WORK
Xtra-vision trading hours range from 10am to 12 midnight. Please indicate the hours you are available for work and we will try to facilitate you as best we can. FROM TO
Sun
Mon
Any comments regarding your flexibility
Tue
Wed
Thur
Fri
Sat
If you have not held a job, have been studying or are returning to work after a break, tell us what you have been doing.
YOUR HOBBIES & INTERESTS
If necessary please use this section to tell us other information about yourself and your experience that you feel will support your application.
Have you ever been convicted of a criminal offence? If 'yes', please give full details.
REFERENCES
Please give the names, addresses and telephone numbers of two people whom we may approach for reference. If previously employed, one of these references should be your current or most recent employer.
Name
Name
Address
Address
Occupation
Occupation
Post Code
Post Code
Phone No.
Phone No.
Please tick this box if present employer should not be contacted without first notifying you
J
By providing the information contained within this application form, you are consenting to its use for the processing of your application and monitoring the efficiency of our recruitment and selection procedures. DATA PROTECTION
DECLARATION
I confirm that to the best of my knowledge the above information is true, accurate and complete. I understand that the Company will reserve the right to dismiss me should the information given by me prove to be inaccurate or misleading in any way. Signature:
Date:
To ensure consideration for interview, please return your completed application form to: Human Resources Dept., Xtra-vision Support Office, Greenhills Road, Tallagt, Dublin 24.
Schools Attended
YOUR EDUCATION & TRAINING
Dates From
Further Education (including college/ university/professional qualifications, raining courses) From
To
To
Examinations Taken/Results
Course/Qualifications
Start with your present or most recent employer and work backwards. Continue on a separate sheet if necessary. Name/Address of Employers Position held & your and Type of Business From To responsibilities Reason for Leaving
YOUR WORK EXPERIENCE
Will you be remaining in the employment of your current employer?
Notice required to leave current employer?
Current rate of pay?
Yes J
No J
PLEASE TELL US HOW YOU FOUND OUT ABOUT THIS VACANCY (Please tick as appropriate)
Local Newspaper
J
Recruitment Poster
J
Via an Xtra-vision employee
School/College/University
J
Other
J
In Store
J
J
(please specify)
OFFICIAL USE ONLY Application Form Date received: P J
R J
H J
Reason:
(Proceed, Reject, Hold)
Initials:
Interview Date: Successful
Job Offered Start Date: Report to:
Comments:
Time: J
Unsuccessful Yes
J
No
Interviewer(s) : J
J
Start Time:
Reserve
J
Job Accepted
Yes J Store:
Initials:
No
J