Vacancies

Date of Birth*

National Insurance Number*

Marital Status
SingleMarriedWidowedDivorced

Place of Birth

Nationality

Have you ever been convicted of a crime?
YesNo

If yes, please explain

Number of Children

Number of Dependents other than spouse/children

Have you ever been terminated?
YesNo

If yes, organization(s), please explain

Have you ever worked at Family Guardian in the past?
YesNo

Reason for leaving

Do you have any relatives in our employment?
YesNo

If yes, state name, relationship and department

Do you own a car?
YesNo

If yes, what is the make and year of the car?

Have you ever sold insurance?
YesNo

If yes, what type?

Have you had any other selling experience?
YesNo

If yes, what did you sell?

Have you ever applied to this Company before?
YesNo

If yes, to which Department

When?

Referred by

Secondary School

School

When?

Graduate

Standard Attained

Achievements: (No. of BGCSEs)

Post Secondary School

School

When?

Graduate

Standard Attained

Achievements: (Degree)

Other Training/Designations

School/Organization

When?

Graduate

Standard Attained

Achievements:

Do you plan to continue your education?
YesNo

If yes, when

Course

Are you a member of:

Rotary, Kiwianis or any other Service Club?

YesNo

Attend Regularly?

YesNo

Hold Office?

YesNo

Any Civic Organizations (e.g. Red Cross)?

YesNo

Attend Regularly?

YesNo

Hold Office?

YesNo

Any Other Organization?

YesNo

Attend Regularly?

YesNo

Hold Office?

YesNo

Do you have any religious customs, which may govern your work hours, dress code or other practices?
YesNo

If yes, please explain:

What hobbies do you have? Please give details below of activities, hobbies and offices held.

Please describe any illnesses you may have had in the past five (5) years:

Do you have any medical conditions (including pregnancy) that warrants ongoing medical treatment or medication?
YesNo

If yes, please describe:

Do you have any medical conditions or impairment that might compromise your ability to perform the duties of the position applied for?
YesNo

If yes, please describe:

In case of an emergency, please provide the name and phone number of the person you wish to be contacted:

Name:

Telephone Contacts Work:

Telephone Contacts Cell

Please write an essay discussing your career aspirations:

I CERTIFY THAT THE ANSWERS GIVEN IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. I UNDERSTAND THAT IN THE EVENT OF EMPLOYMENT, ANY MISREPRESENTATION OR OMISSION OF FACTS IN THIS APPLICATION OR INTERVIEW(S) IS CAUSE FOR DISMISSAL. I FURTHER UNDERSTAND THAT NEITHER THIS APPLICATION NOR ANY OFFER OF EMPLOYMENT CONSTITUTES AN EMPLOYMENT CONTRACT UNLESS FAMILY GUARDIAN AND I EXECUTE A WRITTEN AGREEMENT TO THAT EFFECT. I UNDERSTAND THAT A DRUG TEST AND PHYSICAL EXAMINATION FORM A PART OF THIS APPLICATION PROCESS*. I FURTHER UNDERSTAND THAT IF EMPLOYED I WILL UNDERGO A PROBATIONARY EMPLOYMENT PERIOD.

Signature of Applicant*

Date*

* Please note: All candidates considered for employment will be required to submit copies of BGCSE/Diploma certificates, three written references (including former employer), a recent police certificate (issued within last 6 months), copies of passport information, a copy of your National Insurance card and two (2) passport photos. Additionally, candidates are required to complete a background release form authorizing our Company to perform a background check, in the event that you are given a job offer. This form will be provided to your current employer after you have accepted our job offer.