Application form

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Thank you for applying to Mott MacDonald. As a minimum, please complete this front page and sign page 4 after reading it. You may then either attach your own curriculum vitae OR complete pages 2 and 3. The completion of page 5 (inserted) is not obligatory but is useful for our monitoring purposes.

Position details

Position applied for

Ref MM use only

Location

Applicant details

Title and Surname

ID Number

First name(s)

Other name(s)

Permanent address

Temporary address (if applicable)

Postcode

Postcode

Telephone/HP

Telephone/HP

Home e-mail

Dates at this address

Have you made any previous applications to Mott MacDonald? (if YES, please give details) Yes No

Remuneration package expectations

Disability If you have a disability, please let us know if you require any special help to assist you in the recruitment process.

2

Please complete the education and employment history sections OR attach your own

curriculum vitae

Education

CV attached? Yes No

Postgraduate qualifications

MSc/MBA/PhD/Other Dates

From To

Title/subject of course/thesis

Name of university/college

First degree (if applicable)

Dates Name of university/ college

Name of course Main subjects with examination results or grades to date

From To

Grade Graduation date

Secondary Education

Dates Name of school/college Subjects studied and level (eg GCSE/A/AS/Highers/IB etc)

Give examination results with grades and year

From To

Awards

Details of any awards/scholarships/prizes won at school/university including any sponsorship on degree course

Additional skills/qualifications and achievements

Any other qualifications/computing skills/language ability (please indicate proficiency)

Employment history

(Emphasis on last 10 years, starting with most recent)

3

Dates

From To

Employer’s name, address and type of business

Position held (with brief description of duties)

Basic salary (also show any other

benefits)

International experience

Please list any countries in which you have lived or worked and provide details

Other information

Please add any further information relevant to your application including notes on your specialist interests

Why are you interested in joining PT Mott MacDonald?

Please give the names who recommend you to apply to PT Mott MacDonald Give the names of PT Mott MacDonald Indonesia staff who recognise you You are advised that by signing this document, you confirm, to the best of your knowledge and belief, the information provided is true and correct.

4

If we find that one of the information is untrue or incorrect, you consent to accept any consequences taking by the Company. While you are under no obligation to do so, please help us by completing the insert in this document Signed: Date:

For Mott MacDonald Use only

Date of Interview

Interviewed by (first)

Appointment Recommended?

Yes No

Comments/Notes (continue on a separate sheet if necessary)

Date of Interview

Interviewed by (second)

Appointment Recommended?

Yes No

Comments/Notes (continue on a separate sheet if necessary)

Offer Grade

Job Position Salary

Date Available

Location

MU/DIV/SUB-DIV

Reporting to (Name) Functional Title of Contractual Supervisor

Any special conditions

5

Equal opportunities monitoring

We monitor applications to ensure that our recruitment procedures do not lead to discrimination. The information you supply here will remain confidential. It will be detached from the main form and will not be used by, or be available for use by, anybody involved in selection decisions. Notwithstanding the above we try to keep details of employees' ethnicity, disabilities, religion or religious beliefs and sexual orientation on our Human Resources database for monitoring purposes. If you are successful in securing a position with Mott MacDonald we would like to include the following information in your records. If you are in agreement with this, please also complete your name and date of birth in the section at the bottom of this page and sign the document. You are under no obligation whatsoever to supply these details and your application will be completely unaffected by their absence.

Position applied for

Gender Male Female

Sexual Orientation

Following Employment Equality (Sexual Orientation) Regulations 2003, please use this section to indicate your sexual orientation.

Ethnic origin

Please use this section of the form to indicate the ethnic group to which you belong or from which you are descended. The ethnic origin categories are those specified by the UK’s Commission for Racial Equality and used in the Office of Population Census and Surveys.

Black African1

Black other3 (Specify) Indian

5 White

7 Bangladeshi

9

Black Caribbean 2

Chinese4 Pakistani

6 Irish

8 Other (Specify)

10

Religion or religious belief

Please use this section of the form to indicate the religious group to which you belong. The religion and religious belief categories are those specified by ACAS under the Employment Equality (Religion or Belief) Regulations 2003.

Baha’i1 Hinduism

4 Judaism

7 Sikhism

10

Buddhism2 Islam

5 Parsi

8 No religion

11

Christianity3 Jainism

6 Rastafarianism

9 Other (please specify)

12

Disability

If you have a disability, please provide details below. The Human Resources department will be pleased to discuss with you any special arrangements you may require during your employment.

Applicant details - the completion of this section is entirely voluntary

Surname

Title

First name(s)

Date of birth

Thank you for completing this form.

Heterosexual1

Gay3

Lesbian2 Bisexual

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