Professional Documents
Culture Documents
DATE
REF
MEMBERSHIP OF PROFESSIONAL & OTHER SOCIETIES (state dates and position held)
Name of Employer:
Address of Employer:
Position Held:
Name of Employer:
Address of Employer:
Position Held:
Address of Employer:
Position Held:
Name of Employer:
Address of Employer:
Position Held:
FAMILY DETAILS
OCCUPATION NAME OF
RELATIONSHIP NAME AGE ADDRESS
PRESENT/PAST EMPLOYER
Father
Mother
Brother/
Sister
Spouse
Children
MEDICAL DETAILS
Are you in good health? Yes No If no, why?
Please state with dates, any serious illness, allergies, operations, disabilities or accidents, you had.
ADDITIONAL INFORMATION – Give any additional information which you consider may be of interest to a prospective employer, if
possible state why you believe you are suitable for the position you are applying
Name: Name :
Position: Position:
Name: Name :
Position: Position:
Name of companies with which you have pending application for employment.
(Give dates of application)
1.
2.
3.
Have you applied with this office before? Yes No State Date:
I HEREBY CONFIRM ALL THE ABOVE DETAILS TO BE TRUE AND CORRECT. I AUTHORISE BTI CONSULTANTS TO CARRY OUT REFERENCE CHECKS
WITH PAST EMPLOYERS AND REFEREES IN CONNECTION WITH THIS APPLICATION.
I ALSO AGREE NOT TO SEEK OR ACCEPT EMPLOYMENT EITHER DIRECTLY OR INDIRECTLY FROM ANY CLIENT OF BTI CONSULTANTS TO WHOM I
HAVE BEEN SENT FOR AN INTERVIEW, FOR AT LEAST THREE MONTHS AFTER DATE OF INTERVIEW. SHOULD I ACCEPT EMPLOYMENT WITH ANY
CLIENT OF BTI CONSULTANTS, AND LEAVE WITHIN THREE (3) MONTHS OF THE DATE OF SELECTION, I AGREE TO PAY BTI CONSULTANTS 50% OF
MY CONFIRMED 1ST MONTH’S SALARY.
I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF INFORMATION WILL BE SUFFICIENT REASON FOR WITHDRAWAL OF AN OFFER
OR SUBSEQUENT DISMISSAL, IF EMPLOYED.
Date Signature: