1. Employment Application Form
Personal Details
Date: ________________________________________________________________
Name: _______________________________________________________________
Phone Day Time: _______________________________________________________
Phone After Hours: _____________________________________________________
Mobile: _______________________________________________________________
_______________________________________________________________
Address: ______________________________________________________________
______________________________________________________________________
Marital Status: _________________________________________________________
Dependants: __________________________________________________________
Position Applied For: ____________________________________________________
Previous Employment History: ____________________________________________
_____________________________________________________________________
What do you do in your leisure time? ______________________________________
Number of days sick leave taken in the last two years: ________________________
Do you have any criminal convictions or charges pending? _____________________
Length of employment you are seeking: ____________________________________
What do you expect from this position: _____________________________________

2. Employment Application Form
References and Referrals (Previous employers preferred)
What can you offer Blacks Fasteners Ltd? ___________________________________
______________________________________________________________________
_____________________________________________________________________
Are you willing to present yourself in a well groomed manner on an ongoing basis?
All information given herein is true and correct.
Signed: _____________________________ Date: __________________________
Office Use Only:
Name
Phone Number
Comments