AXA - Careers Opportunities with AXA Northern Ireland

You have selected: Option 2: I want to apply for a position online.

Please complete all sections of the application form, typing Not Applicable (N/A) in any areas which are not relevant.

It will help us to process your application quickly if you provide full and accurate information. particularly about dates, addresses and contact numbers of your employers and referees. Delay could arise if information is omitted.

The following information will assist you in the completion of your Application Form. Please read it carefully as it will help you to provide the information that we will need.

01	POSITION

02	PERSONAL DETAILS Please provide full information including previous surnames/maiden names. Please ensure that the addresses you give cover at least the last 5 years with no gaps and provide dates of residence at each.

03	EDUCATIONAL HISTORY Please provide details of schools/colleges/universities attended. Verification of qualifications may be requested where appropriate.

04	EMPLOYMENT HISTORY In order to process your application we may be contacting past and present employers to obtain evidence of your suitability for the post in question.When completing your employment history, please ensure that you leave no gaps or that any gaps in employment are explained.

05	INTEGRITY Please provide details of convictions and/or court judgements.

06	THIRD PARTY REFEREES Where you are asked to provide a third parry referee, this should be a professional person (e.g. solicitor, doctor teacher or a person of managerial status, fully trained in a professional role). This person must not be a family member.

07	DECLARATION Please re-read your application, to ensure it is accurate before you sign and date.

08	RECRUITMENT MONITORING Our policy is to recruit and develop our staff on the basis of their suitability for the work to be performed, regardless of gender, marital status, religion, ethnic origin, or disability. Please ensure this section is fully completed so that we can monitor the effectiveness of our Equal Opportunities policy. All applicants are asked to answer these questions for monitoring purposes only. The information you give will be treated in confidence and will not form any part of the selection process.

09	DATA PROTECTION ACT AXA considers that protecting your personal information is very important and that you have an interest in how we collect, use and share such information. Information shared on this document will be used by AXA for recruitment purposes only. If successfully appointed to AXA your information may be shared with an external payroll provider.

SECTION 1 — Position Applied For

Vacancy applied for:

Reference Number:

Have you ever applied/worked with for AXA?

If Yes, please give details:

Where did you hear about this vacancy?

SECTION 2 — Personal Details

Surname:

First name:

National Insurance Number (NI)

Previous Full Name (if applicable):

Present address including Postcode: -

Contact details:

Please tick preferred contact method:

Home:

Work:

Mobile:

Email:

How long have you lived at present address?

Previous addresses over the last 5 years:

SECTION 3 — Educational History (See Note 3)

Name and full address of schools, colleges and universities attended

GCSE / A Level / Degree	Result/Grade	Date

Please providel details of your Highest Oualiflcations and brief details of others

Level	Result/Grade	Date

Training courses attended

Subject	Result	Duration & Date

Professlonal Membership

Professional Body & Level of Membership

Are you a member of any professional body? If so, please provide details:

SECTION 4 — Employment History (See Note 4)

Please detail all periods of employment in the last 5 years, starting with the most recent. Please ensure that there are no gaps in the 5 year history or that any gaps in employment are explained.

(A)

Current Employer

Full Name

Address

Telephone Number

Date started / finished: (mm/yyyy)

Start Date	Leaving Date

Basic Salary

Reason for wanting to leave:

Notice Period (Months/Weeks):

Name or person to contact to obtain a reference:

Can we contact the referee now?

Job title and brief description of accountabilities in current role:

Full time/Part—time (Number of hours/days):

(B)

Your previous employers (See Note 4)

Exact dates from and to (day / month / year)

Company/Institution (name, full
address & telephone)

Full Time or Part-time

Job Title & Responsibilities

Reason for leaving

Company/Institution (name, full
address & telephone)

Full Time or Part-time

Job Title & Responsibilities

Reason for leaving

Company/Institution (name, full
address & telephone)

Full Time or Part-time

Job Title & Responsibilities

Reason for leaving

(C)

Have you ever been formally reprimanded, disciplined or dismissed for any reason at work, suspended during an investigation into your conduct or resigned in the face of such investigation, reprimand or dismissal?

If yes. please provide details:

(D)

Other activities induding Voluntary Work, Work Experience and periods of unemployment

SECTION 5 — Integrity

Do you have any Criminal Convictions which are not ‘spent” under the Rehabilitation of Offenders Act 1974? (Motoring offenses should not be included)

If yes, please provide details:

Have you ever been subject to bankruptcy proceedings or court judgements in this country or any other country or are there any proceedings pending?

If yes, please provide details:

SECTION 6 — Third Party References (See Note 6)

We will only seek Third Party References when we are unable to obtain employment references covering the last 5 years.

This should be a Professional Person (eg Solicitor, Doctor, Teacher or a Person of Managerial Status, fully trained in a professional role). This person must not be a family member and must know you in a personal capacity.

Referee name, address and telephone number (for reference purposes only)

Name:

Address including postcode:
(please note we only accept registered
company addresses):

Telephone numbers:

Occupation:

Email:

SECTION 7 — Declaration

Do you need a permit to work in this county?

Please note that in accordance with the Asylum and Immigration Act 1996, the Company needs to ensure it has seen and checked one of a range of documents to show you are eligible to work in Northern Ireland. Before making an offer of employment, you will be asked to forward us one of the following documents. The offer will be conditional on you being able to comply with the Act, we will inspect the document and return it to you as soon as possible.

-	A document issued by your present/previous employer, Inland Revenue, Benefit Agency or Contributions Agency, which contains your National Insurance Number.

-	Birth Certificate issued in the UK or Republic of Ireland.

-	Passport showing you are A British Citizen or have A right of abode here.

-	A passport or National Identity Card showing you are a citizen of the European Economic Area. (EEA countries are all EU countries plus Iceland, Norway and Liechtenstein.}

-	Passport or travel document endorsed to show you have indefinite leave to remain in the UK and are not precluded from taking this employment.

-	UK Residence Permit to show you are A Citizen of an EEA country.

-	A Registration Card which indicates that the holder is entitled to take employment in the United Kingdom.

I understand that any offer of employment will be subject to the receipt of references, which are satisfactory to AXA. Should we not receive satisfactory references, AXA reserves the right to terminate or retract any offer of employment. In this regard I consent to contacting my referees.

I understand that any false, incomplete or misleading information that I give may make me liable, if employed, to dismissal.

Have you held a position in a financial institution? If so, please provide details below. If yes, have you been censured by any regulatory body? Plese provide details:

If employed, I also consent to AXA providing information about me to the regulatory bodies or their agents where applicable to my role. This information may be disclosed to third parties during or post-employment.

Finally, please enter the Security Code in the box to the right to finish your application.