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Scottish Bakery Training Council

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To apply for a Placement on a SAMB Training Programme,
please complete this form.

Personal Details

Title		First Name Surname::
National Insurance Number:

Sex:		Address:
Date of Birth:
Tel No:
Mobile No:
Email:

Do you have a disability? Yes No
(If yes please detail below the nature of your disability and if you are registered disabled, your registration number)

Registartion Number:

Education

Scottish Candidate Number:

Dates: To and From	School/College	Qualifications Gained	Level of Qualifications Gained

Employment History

Present or Last Employer
Name:		Type of Business
Address:		Your position and duties
Date From:		Date To:
Finishing Salary:		Reasons for leaving:

Previous Employer
Name:		Type of Business
Address:		Your position and duties
Date From:		Date To:
Finishing Salary:		Reasons for leaving:

Please give details of your employment history (exluding employment detailed above), that you feel is relavent to this application:

Career Choice (state the type of job you would like to do in the Baking Industry and the reasons for making this career choice):

Which towns and areas could you work in?

Town	Area

To assist SAMB in monitoring it’s equal opportunities policy please complete the following:
Ethnic origin: (please select relevant box)

White		Indian
Black African		Chinese
Black Caribbean		Pakistani
Black Other		Bangladeshi
Prefer not to say		Not known
Other:

References

Please give details of references:

Name	Name	Name

Address	Address	Address

Tel No.	Tel No.	Tel No.

I have completed all details, as appropriate. (Tick)