Personal Details
Last Name *
First Name *
Address 1 *
Address 2
Town/City *
County *
Post Code *
Please tick this box to confirm you are over 18 (this is required for licensing laws)
Email *
Mobile
Telephone *
* Do you require a work permit to work in the UK?
Yes No
If yes, please give details:
* Have you ever worked for or applied to work for Luminar Leisure before?
Yes No
If yes, please give details:
* Do you have alternative employment that you will be undertaking whilst working for Luminar?
Yes No
If yes, how many hours:
What type of work are you looking for? *
Full time Part-time Permanent Temporary
What is your current hourly rate? *
Are you willing to work: *
Evenings Weekends
If you are currently a student would you be interested in working in an alternative unit at term time/holidays?
Yes No
Home/Term Address
Non Term Address
How far do you live from the venue? *
* Do you have facilities for returning home at late hours?
Yes No
Next of Kin - Emergency Contact
Name: *
Telephone: *
Education
Please state, school, college, university, from, to, qualifications and grades. *
Employment
Please fill out your name and address of employer, from, to, position and responsibility and the reasons for leaving. *
References
Please give details of two referees, one of whom should be your current or most recent employer. Friends or family cannot be used as referees.
Reference 1 *
Reference 2 *
Medical Questionnaire
Given the environment in which you may work consisting of flashing light/noise etc. and to enable the Company to better support our employees could you please answer this brief medical questionnaire.
Do you or have you suffered from any of the following:
Diabetes? Fits, epilepsy or blackouts? Respiratory condition? Back problems?
If yes to any of the above, please give details:
* Have you suffered from any other medical condition in the last 5 years?
Yes No
If yes, please give details:
Are you presently on any prescribed medication, if so for what condition?
DECLARATION OF CRIMINAL CONVICTIONS
* Have you ever been convicted of a criminal offence? (Offences deemed as spent under the Rehabilitation Act 1974 do NOT need to be declared here.)
Yes No
If yes, please give details:
STATEMENT
The nature of our business means that the environment in which we work is currently NOT a smokeless environment. If this causes you concern during your work, you must discuss this with your line manager.
Please tick this if you have read and understood this statement:
ENTITLEMENT TO WORK
All prospective staff must produce evidence of their right to work in the UK before they are given employment. Acceptable documents include birth certificate, P45, P60, National Insurance card and passport.
Please tick if you would like to receive information via email from Luminar.
DECLARATION
I give consent to Luminar Plc and its group of Companies to process personal data, and confirm that any individual whose personal information I give the Company, and whose personal data is going to be processed by the Company, have also given their consent for me to do so, in accordance with the Data Protection Act 1998. This includes sensitive personal data, transfer of their information abroad, and the receipt on their behalf of any Data Protection notices. I certify that the information given on this form is correct and I am not withholding any relevant information, I understand that misrepresentation, falsification or omission of factual information requested on this form may lead to dismissal. I understand that if I am offered a position in the Company my engagement will subject to references being received that satisfy the Company, a contractual probation period and to my passing a medical examination if required.
Personal data submitted from this form is not kept beyond dealing with your enquiry.
