GEORDIES TRAVEL LIMITED

Company Registration No# 07722166

This company is located at: 144 West Road, Newcastle Upon Tyne NE4 9QB, United Kingdom

GEORDIES RECRUITMENT VALIDATION FORM

Part 1 Job applied for
Job title Date of Application Method of Application

Personal Information
First Name: Middle Name: Last Name:

Date of birth:

Sex:

Marital Status:

Present address:

Telephone (Home):

Telephone (Work):

Can we contact at work? YES NO

Mobile:

Fax:

Email:

Additional information
When are you available to take up the job?

Copyright @ Geordies Travel Limited Inc. 2012. All Rights reserved.

GEORDIES TRAVEL LIMITED

Company Registration No# 07722166
This company is located at: 144 West Road, Newcastle Upon Tyne NE4 9QB, United Kingdom

What length of notice must you give? Please give details of your current or most recent remuneration package including salary, pension and bonuses. Candidates will be asked for documentary evidence of this if appointed.

Education/qualifications
Please give details of educational and professional qualifications in chronological order. Qualifications and grades Dates

Please give details of any current or planned studies. Course of study and expected qualification Dates

Reference
The Geordies Recruitment Team requires a reference: Your current/most recent employer (or if no employer, your school/university). May we request a reference? Name: At any time After offer of employment

Copyright @ Geordies Travel Limited Inc. 2012. All Rights reserved.

GEORDIES TRAVEL LIMITED

Company Registration No# 07722166
This company is located at: 144 West Road, Newcastle Upon Tyne NE4 9QB, United Kingdom

Job title/position: Telephone: Address: Fax:

Please indicate if this is a work reference or an academic reference Work reference Academic reference

Have you ever been convicted of a criminal offence?

Yes

NO

If yes, please give details of the offence and the sentence imposed. Subject to certain exempted occupations, convictions that are spent under the Rehabilitation of Offenders Act 1974 need not be mentioned. Please be aware that declaring a conviction will not automatically disqualify you from being employed by Mystic.

Part 2
Please note, this section of the form will be detached and given to the Recruiting Manager. The Recruiting Manager and the Interviewing Panel will have access only to information contained in this section.

First Name:

Middle Name:

Last Name:

Jobs applied for

Job title Date of Application Job type (please tick as appropriate) Full-time Part-time Job share UK-based Overseas Application Method

Copyright @ Geordies Travel Limited Inc. 2012. All Rights reserved.

GEORDIES TRAVEL LIMITED

Company Registration No# 07722166
This company is located at: 144 West Road, Newcastle Upon Tyne NE4 9QB, United Kingdom

Management qualifications
Please complete this section if you are applying for management posts (please tick boxes that apply).
TEFL/TESL

Qualification Certificate ELT Diploma ELT First Degree Masters Degree

Date taken

Examining body

Disability
Section One of the Disability Discrimination Act 1995 defines a person as having a disability if he or she has a physical or mental impairment, which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities. It is Geordies policy to interview all applicants who are disabled and who meet the essential criteria for an advertised job. Do you have a disability? (If your answer is yes we will get in touch with you later to ascertain how best to assist you.)

Declaration
I declare that the information I have provided in this application form is, to the best of my knowledge and belief, correct and complete. Warning: if you include any details that you know to be false or if you withhold relevant information, you may render yourself liable to disqualification from the recruitment exercise or, if appointed, to dismissal.

Your signature:

Date:

Copyright @ Geordies Travel Limited Inc. 2012. All Rights reserved.