DATA CONNECTION PRO FORMA

INFORMATION WE WOULD LIKE TO KNOW ABOUT YOU

1.	Full name (including middle name) and date of birth




2.	Home address, email address and telephone number (home and mobile)



3.	Nationality.



4.	Are you interested in working in the US or the UK?


      Depending on your answer, do you require a work permit? 


5.	Have you applied to Data Connection before (and if so, when)? 


6.	Education details (including relevant dates) 

	- GCSE/O (or equivalent) subjects and grades (or exams taken aged 15/16)
	- A level (or equivalent) subjects and grades (or any exams taken aged 
           17 - 19 years of age)
	- university and degree. Please specify the University you attended, degree title 
and result awarded.




7.	Employment history
	- current and previous employers
	- a description of your role and responsibilities
	- reason for leaving
	- remuneration package



8.	Interests (giving details of your main activities or interests)



9.	Career ambition
	- what type of role are you looking for?
	- what do you want/expect from your job? 
	- what made you apply to Data Connection?



10.	Personal characteristics
	- what are your three key strengths?
	- what are the three areas you feel you most need to improve and why?




11.	Health
	- including details of any serious illness or disability



12.	References
	- give the names, addresses and telephone numbers of two referees (we will not 
contact those marked with an asterisk (*) without your permission)





13.	Any additional information



...............................................................................................................

Declaration Form 

If you are sending this form in electronic format then we will ask you to sign this portion if 
you attend an interview with us.

In the context that Data Connection assumes that candidates are reasonable and honest, I 
confirm that no information has been omitted which is relevant in evaluating me as a 
potential employee and that all information supplied is accurate. (We would consider 
information regarding serious misdemeanours to be relevant.) 

By submitting my application, I consent to Data Connection storing information about me 
relating to my application or future employment, both electronically and on paper.





Signed ________________________  Date:      _______________________



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