Job Application Form

PERSONAL INFORMATION

First Name

Middle Name

Last Name

Where do you currently reside

P.O. Box

Post Code

Present Address

E-mail Address

Main Phone

Alternative phone

Date of Birth

Nationality

IMMIGRATION STATUS

Do you have the right to work in Cayman Islands, without the need for a work permit?

Yes

No

Immigration Status

Are you currently employed?

Yes

No

Can we contact (your) current employer?

Yes

No

Have you applied at PDL before?

Yes

No

What year did you apply?

What date are you available to start?

Do you have any relatives currently employed by this company?

Yes

No

EDUCATION

What is your education level?

Name of institution

Location of Institution

Did you graduate?

Yes

No

What year did you graduate?

FORMER EMPLOYERS

If the applicant has no previous jobs or held less than 3 jobs (including his present job), then he/she should answer each question with, “N/A”, as and where applicable.

Employer # 1

Is this your current employer?

Yes

No

Name of Employer

Position

Years worked

Name of supervisor

Salary

Reason for leaving

Employer # 2

Is this your current employer?

Yes

No

Name of Employer

Position

Years worked

Name of supervisor

Salary

Reason for leaving

Employer # 3

Is this your current employer?

Yes

No

Name of Employer

Position

Years worked

Name of supervisor

Salary

Reason for leaving

MANDATORY REQUIREMENTS

Police Record

Date issued

Country

Passport issued by country

Passport Number

Passport Expiry date

Driver’s License (required for WH Selector/Driver; Delivery driver and Sales Representatives)

Driver’s License Number

Driver’s License Expiry

Country

Driving Record – required for WH Selector/Driver; Delivery driver and Sales Representatives
(upload in attachments- section I)

Industrial Truck Operator Certification – required for WH Selector/Driver; Delivery driver
(upload in attachments- section I)

Forklift or Warehouse Operator Certification - required for WH Selector
(upload in attachments- section I)

Do you have the experience but not the certificate?

Yes

No

Can you obtain?

Yes

No

This certification is required in order to be eligible for this job opening.

PHYSICAL RECORD AND ADDITIONAL INFORMATION

Do you have a physical condition, which may limit your ability to perform the job applied for?

Yes

No

Please explain

Do you have a medical condition, which may limit your ability to perform the job applied for?

Yes

No

Please explain

Do you have any allergies?

Yes

No

Please explain

Would you be prepared to take random Drug Tests?

Yes

No

Have you ever been charged or convicted of any felony?

Yes

No

Please explain

Have you ever been charged or convicted of any drug related crimes?

Yes

No

Please explain

Do you have any pending felony charges?

Yes

No

Please explain

Do you have any pending drug related charges?

Yes

No

Please explain

Can you work on Weekend and Public Holidays?

Yes

No

REFERENCES

Reference #1

Name of reference

Phone number

Business

Number of years known

Reference #2

Name of reference

Phone number

Business

Number of years known

Reference #3

Name of reference

Phone number

Business

Number of years known

Do you have any Employment Reference Letter(s)?

Yes

No

Reference Document