Regency Pizza Application Form


    First Name

    Surname

    Gender

    Date of Birth

    Telephone Number

    Mobile Number

    Email Address

    National Insurance

    Address

    Town

    Postcode

    Driving License?

    Driving Endorsements?

    Driving Endorsement additonal info

    Job Role

    Store

    Type of Job

    How will you get to work?

    Is your store location flexibile?

    What are your available times to work?



    Monday Start

    Monday Finish

    Tuesday Start

    Tuesday Finish

    Wednesday Start

    Wednesday Finish

    Thursday Start

    Thursday Finish

    Friday Start

    Friday Finish

    Saturday Start

    Saturday Finish

    Sunday Start

    Sunday Finish

    Describe your overall Health

    How many sick days have you taken in the last year

    Do you suffer from any of the following illness'?

    ANoneAllergiesDiabetesAsthmaSkin DiseaseSerious Ear/Nose/Throat InfectionEpilepsy/BlackoutsOther


    Any other illness'?

    Do you have a Criminal Record?



    If yes, please give details

    Qualifications

    Previous Jobs

    Marital Status

    Ethnic Origin

    Disability Status

    Signature

    Today's Date