Name *

First Name

Last Name

Phone *

(###)

###

####

Criminal Convictions

Have you ever been convicted or cautioned in relation to any criminal offence, have you been bound-over, or subject to formal warnings or are you at present the subject of any criminal proceedings or police investigation?

Yes

No

The Mayfield Trust is a Disability Symbol user. This means that any applicant with a disability who meets the essential criteria for a job vacancy will be guaranteed an interview and considered on their abilities. *

Do you consider yourself to have a disability?

Yes

No

Date from *

MM

DD

YYYY

Date to *

MM

DD

YYYY

Date from

MM

DD

YYYY

Date to

MM

DD

YYYY

Do you hold a full, clean current driving licence valid in the UK? *

Yes

No

Are you a UK citizen? *

If you are not a UK citizen, can you provide proof of permission to work in the UK? (We will ask you to provide a check code so we can verify this online prior to interview).

Yes

No

Expiry date

MM

DD

YYYY