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APPLICATION FORM

DAWSONGROUP PLC PRIVATE AND CONFIDENTIAL


(PLEASE COMPLETE DETAILS IN
FULL)

VACANCY REFERENCE NUMBER: MKC 76298 FULL TIME X PART TIME TEMPORARY CASUAL

POSITION APPLIED FOR: Graduate research assistant

Title:
Mr Marital Status: Single
Mr/Mrs/Miss/Ms etc:
Date of Birth:
First Name(s): Dominic 28/04/1987
Surname: Age: 22
Butcher
Maiden Name: No. of children: 0

Do you require an UK
Preferred to be known as: Dominic YES NO X
work permit?

Address 1 2 Butterton Gardens Tel number 01908665730


(home)
Address 2: Broughton Tel number
(work)
Town: Milton Keynes Preferred contact 01908665730
Telephone No:
County: Buckinghamshire Postcode: MK10 7BU Would you have to
YES NO X
relocate?

Have you a current driving licence? YES NO X Do you have any offence points endorsed? YES NO X

For what classes of vehicle? Number of points endorsed (if any)?

Do you have your own transport? YES NO How would you normally travel?

Have you ever had your driving licence revoked? YES NO If YES please give details

     
EDUCATION HISTORY
Dates Name & Address of Secondary School(s) attended (in date order) Type of School
From To
1999 2005 Stantonbury Campus Comprehensive School
            Milton Keynes      
            MK14 6BN      
                       
                       
Dates Name & Address of University, College, Polytechnic, Institute etc Course Title or
attended (in date order) Subjects Studied
From To
2005 2008 Leicester University BA HONS American Studies
      University road      
      Leicester      
      LE1 7RH      
                 
EXAMINATION RESULTS/ QUALIFICATIONS OBTAINED
Date Subject Examination Grade Date Subject Examination Grade
2008 American Studies University undergraduate 2:2 2003 English Language GCSE B
degree
2005 History A level C 2003 English Litriture GCSE B
2005 Communications A level B 2003 English Humanities GCSE B
Studies
2005 Government A level C 2003 Media Studies GCSE C
&Politics
2005 General Studies AS level B 2003 Drama GCSE C
2003 Maths GCSE C

PLEASE USE SEPARATE SHEET FOR ANY ADDITIONAL INFORMATION IF REQUIRED

I am very keen to apply for this 9 month position. I am enthusiastic about the possibility of using the research skills I
gained on my degree to conduct a feasibility study into the demand of renting trailers for static storage in the UK
commercial property market. I enjoyed using the web to research up to date information that I used in my dissertation.

I have excellent interpersonal skills and enjoy using them as a presenter on radio MK (as I did on campus radio show
which I presented at University). I am confident presenting to groups and working as a member of a team. I am used to
communication by telephone.

I have a sound general education gained from my undergraduate studies at the University of Leicester and my successful
A level and GCSE studies at Stantonbury Campus. I have a basic knowledge of the commercial property market and am
keen to learn more in the context of this role.
EMPLOYMENT HISTORY Details of your last / current employer (please complete all details in full)
Position / Job Title Usher, door steward, barman (Volunteer) From April 2009 To June 2009
Company Name The Stables theatre No. of Employees      
Address 1       No. reporting direct to you      
Address 2       Starting remuneration (Basic Salary) £      
Town Milton Keynes Starting Bonus etc entitlement £      
County Buckinghamshire Remuneration now /on leaving (Basic Salary) £      
Postcode       Bonus etc entitlement now /on leaving £      
Nature of business      
Who were you responsible to? Theatre manager, head usher
Why do you /did you wish to leave? Volunteer
DETAILS OF PREVIOUS EMPLOYERS (in date order) (please complete all details in full)
Position / Job Title Graduate trainee (Volunteer) From January 2009 To March 2009
Company Name University of Northampton IT department No. of Employees      
Address 1       No. reporting direct to you      
Address 2       Starting remuneration (Basic Salary) £      
Town Northampton Starting Bonus etc entitlement £           
County Northamptonshire Remuneration now /on leaving (Basic Salary) £      
Postcode       Bonus etc entitlement now /on leaving £      
Nature of business      
Who were you responsible to?      
Reason for leaving? Volunteer
(please complete all details in full)
Position / Job Title Part time steward and turnstile operator From 2004 To 2006
Company Name MK Dons FC No. of Employees      
Address 1       No. reporting direct to you      
Address 2       Starting remuneration (Basic Salary) £ 17
Town Milton Keynes Starting Bonus etc entitlement £      
County Buckinghamshire Remuneration now /on leaving (Basic Salary) £ 25
Postcode       Bonus etc entitlement now /on leaving £      
Nature of business      
Who were you responsible to? Head Steward and Turnstile operator
Reason for leaving? University commitments
(please complete all details in full)
Position / Job Title       From       To      
Company Name       No. of Employees      
Address 1       No. reporting direct to you      
Address 2       Starting remuneration (Basic Salary) £      
Town       Starting Bonus etc entitlement £      
County       Remuneration now /on leaving (Basic Salary) £      
Postcode       Bonus etc entitlement now /on leaving £      
Nature of business      
Who were you responsible to?      
Reason for leaving?      

HEALTH
Are you of good health? YES NO To the best of your knowledge are you fit to perform the duties involved YES NO
X in the position applied for? X
Are you registered YES NO If registered as disabled       Expiry Date      
disabled? please give number
Would you be willing to have a medical YES NO Are you a YES NO No. per day      
examination if deemed necessary? X smoker? X
HAVE YOU AT ANY TIME SUFFERED FROM ANY OF THE FOLLOWING CONDITIONS? PLEASE √ APPROPRIATE BOX
YES NO YES NO YES NO
X Back trouble, or X Nervous breakdown or X
Dermatitis or skin trouble
slipped disc Mental trouble
X X X
Rheumatism, Arthritis,
Gastric or Duodenal ulcer Rupture or Hernia
Fibrosis
X X X
Deafness, Ear infections Do you always wear glasses
Any deformity
Sinusitis or contact lenses?
X X Do you wear glasses or X
Chest trouble, Bronchitis, Fits, Fainting attacks,
contact lenses for close
Asthma, T.B., Hayfever Giddiness, Epilepsy
work?
X X Have you had a serious X
Rheumatic fever, Heart
Migraine accident at work or
trouble
elsewhere?
X X X
Swollen ankles, Varicose Are you currently receiving
Diabetes
Veins any medical treatment?
If Yes, to any of the above, please state details of any illness or injuries suffered:
     

PRACTICAL SKILLS
Summarise job skills acquired and specialist training received I am currently undertaking a ten point Open University course in web
design that I am enjoying greatly and finding extremely useful. The
graduate work I did for Northampton University introduced me to
technical problems in IT and how to solve them. In my own use of IT
I am competent in Microsoft word, excel, power point, audacity and
web searching.
Foreign languages ability-written/ spoken      

     

What qualities do you have which most suit you to the job you are I am very happy to work hard on specific tasks and enjoy the
applying for? opportunity to organise my approach to research autonomously. I
am doggedly persistent at completing tasks and I am adept at
making connections between data and ideas. I am also a good team
player and use my inter-personal skills to ensure colleagues are
included.
     

     

GENERAL
Have you previously worked for the group? YES NO X If yes, please give details      

     

What are your main interests, sports and hobbies? Football, Cricket, Film, Music, Current affairs, Politics ect

     

What professional bodies or trade unions do you belong to?      

     

Do you have any part-time jobs? YES X NO If yes, please give details Volunteer presenter on radiomk.co.uk

     

Do you have any other commitments, which might limit your YES NO X If yes, please give details      
working hours? E.g. Judicial, Military or Local Government.
     

Future training plans. Give details of any courses you intend to pursue. Currently undertaking ten point course at the Open University
titled T183 Design and the Web.
     

Have you ever been dismissed from employment? YES NO If Yes, please state reason      
X
     

Have you ever been convicted of a criminal offence? N.B Rehabilitation of Offenders Act YES NO
X
If Yes, please state reason      

REFERENCE REQUESTS : N.B: References will also be sought from previous employers covering a period of the past two years.
Experience Please complete all details in full Character Please complete all details in full

Name Ms Judy Devison Name Alex Wadden

Address 1 Stantonbury Campus Address 1 Department of politics


Address 2 Purbeck Address 2 University Road

Town Milton Keynes Town Leicester

County Buckinghamshire County Leicestershire

Postcode Mk14 6bn Postcode LE1 7RH

Job Title Tutor Occupation Lecturer

Tel. no 01908 220066 Tel. no      

Can we YES What is your Can we YES What is your Dissertation


NO A level tutor NO
contact now? X Relationship? contact now? X Relationship? supervisor

AVAILABILITY

When would you be available for interview? Yes

If offered this job when would you be able to start?


As soon as possible

Do you have any holiday commitments? No

WHERE DID YOU HEAR ABOUT THIS JOB? PLEASE GIVE DETAILS
Jobcentre
(please state which X Milton Keynes
town/location)
Newspaper advertisement
     
(please state paper and area)

Internet
     
(please state which site)

Employee Introduction
     
(please state name)

Recruitment agency
     
(please state which one)

Other source
     
(please state details)
Have you seen the Dawsongroup Do you
web site? have any      
(www.dawsongroup.co.uk) comments?
Do you know anyone employed NO If yes, please state
YES      
by the group? X their name
If yes, what is your relationship
     
(e.g. friend, relative etc)
DATA PROTECTION ACT 1998: The information provided on this application form will remain private and confidential and will be
used for the purpose of selection and recruitment. Where the application is successful the company may, from time to time thereafter,
wish to process this information (as updated periodically) for personnel administration and business management purposes. Where this
is the case, processing will take place in accordance with the provisions of the Data Protection Acts 1984 and 1998. By signing this form
you will be providing the company with your consent to these uses.
DECLARATION : I declare that to the best of my knowledge and belief all particulars I have given are complete and true. I understand
that any false declaration or misleading statement or any significant omission may disqualify me from employment and render me liable
for dismissal. I understand that any job offer is subject to satisfactory references and a probationary period and (if the company believes
it appropriate) a satisfactory medical report.
Applicant’s Signature
Dominic Butcher Date 17/11/2009

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