Employment

Application Form
Private & Confidential

POSITION

Ref. No (if applicable)

Blockbuster Store Location

Position Applied For:

Store Management Customer Sales Representative Full-Time Part-Time

Temporary Other (specify)

Please specify availability:-

Mon Tue Wed Thur Fri Sat Sun

From

To

How many hours would you wish to work per week?

If you are offered this position, will you continue to work in any other capacity? Yes/No*

If Yes please state:

Date available to start:

Have you worked for Blockbuster before? Yes/No* If Yes which store(s)?

Date(s): From To Reason(s) for leaving?

How did you hear about the job?(reference number if applicable)

What has attracted you to work for Blockbuster?

 PERSONAL DETAILS

Surname Forename(s) Mr/Mrs/Miss/Ms

Address

Postcode:

Telephone Number Home: Work: Mobile:

NI Number:

Are you eligible to work in the UK? Yes/No* ______________________________________

Have you ever been convicted of a criminal offence? Yes/No*

If ‘Yes’, please give details (under the Rehabilitation of Offenders Act 1974, spent convictions
need not be declared)

EDUCATION & TRAINING

School/University/College Examinations taken and results

(Address & Tel Number)

From To
School/University/College Examinations taken and results

(Address & Tel Number)

From To

Please explain your Computer Skills/Experience:

 DETAILS OF PREVIOUS EMPLOYMENT (Most recent job first)

Company name & Dates Job Title Main Reason For

Address (From & Responsibilities Leaving
To)

Salary £

Salary £

References
Please give names and addresses of two referees, one of whom must be your present or most
recent employer or your school, university or college. Where possible, we require references
from two previous employers. If you have no present or previous employer, please give details
of whom we can contact for a personal or educational reference.

Name

Job Title/Relationship

Company/Institution

Address Postcode

Telephone No

May we contact the above referee prior to making the job offer: Yes/No (Delete as applicable)

Name

Job Title/Relationship

Company/Institution

Address Postcode

Telephone No
May we contact the above referee prior to making the job offer: Yes/No (Delete as applicable)

PRODUCT KNOWLEDGE

What’s your favourite movie?

In one sentence, how would you recommend the above movie to a customer?

How many movies do you watch on average per month?

 We are committed to equality of opportunity in employment and our aim is to
ensure that all applicants are considered solely on their merits. Information on
ethnic/racial origin is strictly confidential and is used for statistical purposes only. If
EQUAL OPPORTUNITIES you decide not to give this information, your application will not be affected in any
way, as this section will not be used for short-listing purposes.

Personal Details: Last Name First Name

Date of Birth Gender: Male Female

Ethnic Monitoring

The Commission for Racial Equality recommends that employers should use the 2001 Census categories
in order to monitor the ethnicity of their staff.

(a)White: British: Irish:

Any other white background please specify.

(b)Mixed: White and Black Caribbean: White and Black African: White and Asian:

Any other mixed background please specify.

(c)Asian or Asian British: Indian: Pakistani: Bangladeshi:

Any other Asian background please specify.

(d)Black or Black British: Caribbean: African:

Any other Black background please specify.

(e)Chinese or Other ethnic group: Chinese:

Any other ethnic group please specify.

Disability
We are committed to assisting people with disabilities to obtain and remain in employment. We will
therefore endeavour to provide reasonable adjustments to equipment and premises when required.

Do you have a disability? Yes/No*

Please give details of the effects of any disability or any long-term medical condition (over the

last 12 months) and any assistance you need.

Declaration
I understand that misrepresentation, falsification or omission of factual information requested on this
application form may constitute Gross Misconduct, which may result in dismissal. Prior to any offer of
employment being made I understand that I shall have to provide evidence of my eligibility to work in the
UK. I agree to the company recording my data and disclosing information contained on this form to third
parties. I also agree to the company contacting my present and/or previous employer for a reference.

Signature Print name Date

PLEASE HAND IN TO YOUR PREFERRED STORE OF EMPLOYMENT.