THE INFORMATION YOU SUPPLY ON THIS FORM WILL BE TREATED IN CONFIDENCE AutoCoding Systems Ltd Application Form 1 Personal details2 Rehabilitation of Offenders Act3 Education4 Employment Record5 References6 Declaration Please select the post you are applying for*-Business Development ManagerGraduate Software DeveloperGraduate Software TesterTitle*-Mr.Mrs.Miss.Name* First Last Address* Address Line 1 Address Line 2 City County Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home telephone numberMobile telephone number*National Insurance Number*Are you eligible to work in the UK?*YesNoPlease state current or desired Salary Package including benefits & holidays* Have you ever been convicted of a criminal record?*YesNoDo you have any prosecutions pending?*YesNoPlease give details/dates of offence(s) and sentences* Education*Name of School/UniversityDate fromDate ToExaminations taken and Qualifications gained (Specify Grades) Employment Record*Name and address of employer or work experienceDate fromDate ToJob Title / Job Function / ResponsibilitiesSalary and reason for leaving Reference 1Please give the names and addresses of your first most recent employer (if applicable). If you are unable to do this, please clearly outline who your referees are. (NB. References will only be taken if you commence employment with us)Name First Last Their position (job title)Work relationshipOrganisationDate employed from Date employed to Address Address Line 1 Address Line 2 City County Postal Code Phone numberEmail Reference 2Please give the names and addresses of your second most recent employer (if applicable). If you are unable to do this, please clearly outline who your referees are. (NB. References will only be taken if you commence employment with us)Name First Last Their position (job title)Work relationshipOrganisationDate employed from Date employed to Address Address Line 1 Address Line 2 City County Postal Code Phone numberEmail I confirm that the information provided in this application and within my Curriculum Vitae is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file. Signed*Date* This iframe contains the logic required to handle Ajax powered Gravity Forms.