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Job Application

Thank you for your interest in Puckator. Please use the following form to submit your application to us.

Fields marked with a * must be completed.

Job Reference/Title - Title or Reference Number of the job you would like to apply for.
Personal Information - Please provide your contact details.
First Name:*
Last Name:*
Tel No:*
Previous Employment - Please provide details of your previous employment. Include dates when you were not working.
Employer (Name and Address):
Dates (From-To):
Position held and Description of Duties:
Reason For Leaving:
Employer (Name and Address):
Dates (From-To):
Position held and Description of Duties:
Reason For Leaving:
Employer (Name and Address):
Dates (From-To):
Position held and Description of Duties:
Reason For Leaving:
Education and Training - Please provide details on all levels of your education as well as relevant training courses. Include: Name of School/College, Dates Attended, Subjects Studied and Qualifications Gained.
Other Reasons for Job Suitability - Please include any further information that shows why you want to work in this position and what skills you can bring to the role.
Job References - Please provide 2 references including your current employer, or if currently unemployed, your previous employer.
1. Company Name:
Contact Name:
Contact Position:
Tel No:
2. Company Name:
Contact Name:
Contact Position:
Tel No:
Criminal Convictions - This position is not exempt from the Rehabilitation of Offenders Act 1974, therefore we only ask you to disclose convictions which are unspent. In the event of employment being offered, failure to disclose all unspent convictions could result in dismissal or disciplinary action. All information will be treated in confidence and will only be taken into account when absolutely necessary. Any information given may be held on computer, and therefore falls within the Data Protection Act.
Have you ever been cautioned or convicted of a criminal offence, or have any hearing pending?
Yes No
If yes, please provide details
Health Details - As our work will involve physical aspects such as heavy lifting, it is important that we understand if you have suffered from any previous health issues in order to support you in the role.
Do you have any impairment which might have a substantial or long term effect on your ability to carry out day to day activities for this role?
Yes No
If so, please describe how you would be able to perform the job with reasonable adjustments:
Please specify any special arrangements or reasonable adjustments you may require to attend an interview:
DECLARATION (Please read this carefully before ticking the box):

I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.
I agree that this information will be retained in my personnel file during my employment and up to six years thereafter and understand that information will be processed in accordance with the Data Protection Act. *

Security Question: What's 5+5? (write the word) *
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Company Reg No: 3413131 - Company VAT No: 464963410