Dawsons Music Ltd
Head Office : 65 Sankey Street, Warrington, WA1 1SU
Tel: 01925 632591 email: [email protected]
NOTE ON COMPLETION OF APPLICATION FORM
Please complete the form in type or black pen as it will be photocopied and distributed to those Dawsons Music Ltd
employees directly involved in the selection process.
The information that you provide on this form and that obtained from other relevant sources will be used to process your
application for employment. The personal information that you give us will also be used in a confidential manner to help us
monitor our recruitment process. Candidate details are held in secure filing systems for up to 6 months following receipt.
Dawsons Music Ltd will hold personal details in order to communicate with candidates, and for statutory purposes (equal
opportunities).
If you succeed in your application and take up employment with us, the information will be used in the administration of your
employment with us. We may also use the information if there is a complaint or legal challenge relevant to this recruitment
process.
We may check the information collected, with third parties or with other information held with us.
By signing this form we will be assuming that you agree to the processing of sensitive personal data (as described above), in
accordance with the Data Protection Act 1998.
SECTION ONE: JOB DETAILS
Position Applied for:
Date of Application:
Where did you hear about the vacancy?
SECTION TWO: PERSONAL DETAILS
Address:
Full Name:
Email Address:
Home Telephone:
Mobile Number:
Preferred method
of contact:
Car Driver:
Yes

No

Do hold a full
current driving
license?
Yes

No

This will only be taken into consideration where driving is a requirement
of the job
Please give details of any endorsements /
disqualifications
Page 1 of 6
Application Form Version 1.0 [2014]
SECTION THREE: EDUCATION AND TRAINING
Please summarise your education, qualifications and training, relevant to the post for which you are applying. Please
give grades where applicable and state whether the course was full time or part time.
SECTION FOUR: EMPLOYMENT HISTORY / WORK EXPERIENCE
Please give details of all the posts you have held since leaving full time education, starting with your current or most
recent post.
Current or Most Recent Employer’s Name and Address
Dates Employed
From:
To:
Basic Annual Salary:
Bonus/Commission and
Additional Reward
Position(s) held:
Summarise the nature of the work, your job responsibilities and achievements attained
Reason for Leaving:
Page 2 of 6
Application Form Version 1.0 [2014]
Previous Employer’s Name and Address
Dates Employed
From:
To:
Basic Annual Salary:
Bonus/Commission and
Additional Reward
Position(s) held:
Summarise the nature of the work, your job responsibilities and achievements attained
Reason for Leaving:
Previous Employer’s Name and Address
Dates Employed
From:
To:
Basic Annual Salary:
Bonus/Commission and
Additional Reward
Position(s) held:
Summarise the nature of the work, your job responsibilities and achievements attained
Reason for Leaving:
Please continue on a separate sheet if necessary
Have you ever been dismissed from employment?
If yes please give details:
Page 3 of 6
Application Form Version 1.0 [2014]
Yes

No

SECTION FIVE: REFERENCES
Please give names and addresses of two people to whom we may apply for a work reference. Where work reference is not
available, education references should be used and may be considered.
Referee 1
Referee 2
Name:
Name:
Position:
Position:
Company Name
& Address:
Company Name
& Address:
Telephone No:
Telephone No:
Email Address:
Email Address:
May we contact this referee once a
verbal conditional offer of employment
is made?
May we contact this referee once a
verbal conditional offer of employment
is made?
Yes
 No 
Yes
 No 
SECTION SIX: SUPPORTING EVIDENCE
Using the job description supplied, please tell us why you think you would be a good candidate for this post. If you wish,
please include relevant aspects of your non-paid work experience or voluntary activities.
Please continue on a separate sheet if necessary
SECTION SEVEN: FURTHER INFORMATION AND DECLARATION
Criminal Convictions
You are not required to declare “spent” convictions as set out in the Rehabilitation of Offenders Act 1974. If you wilfully suppress
any information except as provided under the Rehabilitation of Offenders Act 1974, you will risk losing the appointment.
You should tell the Company immediately if any charge is brought against you after completing this form and before you take up
any appointment.
Have you ever been convicted of a criminal offence which is not
‘spent’ under the Rehabilitation of Offenders Act 1974*?
*Please refer to http://www.justice.gov.uk/guidance/docs/rehabilitationoffenders.pdf if you require clarification on the above.
Yes

No

If yes, please give details on a separate sheet sealed in
an envelope, marked ‘Private & Confidential’. Failure to
do so may lead to disqualification from the recruitment
process or later dismissal if appointed.
Any applications for posts working either directly or indirectly with children and/or vulnerable adults are exempt from the
Rehabilitation of Offenders Act 1974. Applicants for these posts will therefore be required to disclose any cautions, reprimands,
final warnings and convictions, even those that are considered ‘spent’, as part of the application process and will be required to
complete a DBS check before an appointment is confirmed. Dawsons Music Ltd will not discriminate unfairly against applicants
with a criminal record and having a criminal record will not necessarily bar an individual from working for Dawsons Music Ltd.
Please only answer the two questions below if the role you are applying for specifies the requirement for an Enhanced Disclosure
& Barring Service check and an exemption from the Act. This will be stated in the advert and person specification.
If you are applying for a role which specifies an exemption from
the Act, have you at any time received, or had pending, a court
conviction, caution, reprimand or final warning?
Page 4 of 6
Application Form Version 1.0 [2014]
Yes

No

If yes, please give details on a separate sheet sealed in
an envelope, marked ‘Private & Confidential’. Failure to
do so may lead to disqualification or later dismissal if
appointed.
I consent to an Enhanced Disclosure & Barring Service check
Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

General
Do you have any other employment (e.g. part time work)?
If yes, please give brief details:
Do you have any other commitments which might limit your
working hours (e.g. judicial, military or local government)?
If yes, please give brief details:
Are you related to, or do you know any staff at Dawsons Music?
If yes, please give brief details:
Availability
If currently employed, how much notice are you required to give?
Do you have any holiday commitments or dates you are unable to
attend interview?
If yes, please give brief details:
Eligibility to work in the UK
Do you require a visa
to work in the UK?
Yes

If yes, please state
the type of visa:
No

If required, do you
hold a valid visa?
Yes

No

Expiry Date:
Declaration
I declare that the information I have given in this application and my CV is accurate and true. I understand that providing
misleading or false information will disqualify me from appointment OR, if appointed, may result in my dismissal.
Signed....................................................................................................
Page 5 of 6
Application Form Version 1.0 [2014]
Date
...........................................
EQUAL OPPORTUNITIES
Please separate from your application form and place in a sealed envelope marked private and confidential
Dawsons Music recognises and actively promotes the benefits or a diverse workforce and is committed to treating all
employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We
therefore welcome applications from all sections of the community.
This section of the application form will be detached from your application and will be used solely for monitoring purposes.
 Prefer not to say
Date of birth:____________________________
 Prefer not to say
 Prefer not to say
 Prefer not to say
Gender:________________________________
Marital Status:___________________________
Sexual Orientation:_______________________
Ethnic & Cultural Background
White:
British
details)
Irish
Any other white background (please give
Mixed:
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed background (please
give details)
Asian or Asian British:
Indian
Pakistani
Bangladeshi
Any other Asian background (please
give details)
Black or Black Caribbean:
Caribbean
(please give details)
African
Chinese or other ethnic group:
Chinese
Any other Black background
Any other background (please give details)
 Prefer not to say
Disability
The Equality Act 2010 defines a disabled person as anyone with a “physical or mental impairment which has a substantial and
long term adverse effect upon his/her ability to carry out normal day to day activities”.
Do you consider yourself to have a disability?
 Yes  No
 Prefer not to say
If Yes, please give the nature of the disability:
 Prefer not to say
Religion or Belief: ___________________________
Signed....................................................................................................
Page 6 of 6
Application Form Version 1.0 [2014]
Date
......................................