We are committed to an equal opportunities policy in employment and welcome applicants for jobs irrespective of disability, marital status, race or sex. To enable us to monitor this policy,this application form includes questions relating to these topics.

Please fill in the online application form below, or print off the PDF version and send it to:
The Bell, Church St, Eckington, Pershore, Worcestershire, WR10 3AN

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Personal Particulars
Your Name

Telephone No


Ethnic Group

If Other Please Specify

Marital Status

Ages of Children(if applicable)

If you are registered disabled, please give number:

Please state which job you are applying for (e.g., bar staff)

For the following, please check the relevant box, in all cases
Do you, or have you ever suffered from: Yes No
Typhoid fever
Paratyphoid fever
Fits or blackouts since the age of 5
Recurring ear infections
Recurring skin trouble affecting hands, arm or face
Recurring disabilities affecting standing, walking, lifting or use of hands

At present, are you suffering from: Yes No
A discharging ear
Boils, styes or septic fingers
A cough with phlegm
Abdominal pain, diarrhoea or flu
Skin trouble affecting hands, arms or face

Previous Employment
Name & address Details/Salary
Reasons for leaving From


Name & address Details/Salary
Reasons for leaving From


About You Starting Work
If you were to be offered a job at The Bell, what do you feel you would bring. (personality, previous experience etc) Please give details on what days/times you would be eligible to work if offered the vacancy.

Please give the name and address of two referees,at least one of whom must be a past or present employer (if applicable)