This document is a job application form for Bientott, an organization committed to equal opportunity. The form collects personal information in two parts. The first part requests contact details and background information to ensure no bias in the recruitment process. The second part, only seen by the hiring manager, requests relevant experience and qualifications for the role. It asks the applicant to describe their interest in the role and skills that make them a strong fit. The applicant must declare that all information provided is truthful before submitting the application.

1. SURVEY: Job Application Form
Bientott” is committed to a policy of equal opportunity and the development of positive policies to
promote equal opportunity in employment around the word.
This form is in two separate parts: the first part contains personal information and is a confidential
document, which will not be seen by those making a selection decision and the second part relates
specifically to the post(s) you are applying for.
FIRST PART
Job Reference Number PositionApplying For DesiredLocation
We aim to ensure no applicant or employee receives less treatment on the basis of gender including
transgender, marital status or civil partnership, religion and belief, political opinion, race, colour, nationality
or ethnic origin, work pattern, age, disability or Health status, socio-economic background, spent
convictions, trade union activity or membership, on the basis of having or not having dependants, or any
other irrelevant grounds.
We welcome applications from all sections of the community as we believe that a diverse workforce gives
added depth to our work. Please answer the questions below, which will help us ensure there is no hidden
bias within our recruitment process.
PERSONAL INFORMATION
Surname/Family Name Title (Dr, Ms, etc)
First Names
Present Address
Date of Birth
Marital Status Example: Single , Married
Gender Example : Male , Female
E-mail Address
Telephone Numbers (Home) Mobile Number

2. EDUCATION/QUALIFICATIONS
Please give details of your education and professional qualifications in chronological order.
Dates
Educational Institution Qualifications and grades
From To
Please give details of any relevant professional qualification; including membership of any relevant
professional bodies and any relevant job-related training that you have undertaken:
PLEASE GIVE DETAILS OF ANY CURRENT OR PLANNED STUDIES.
Course of study and expected qualification Dates
REFERENCES
Schlumberger Limited requires two references:
REFEREE 1
Full Name
Job Title/Position
Address
Email Address
Telephone Number Fax Number
REFEREE 2
Full Name
Job Title/Position

3. Address
Email address
Telephone Number Fax Number
Referees will be contacted once you have accepted a provisional offer and not before. By returning this
application form you are giving your permission for the Company to contact the referees at the stated
time.
Have you ever applied to or interviewed by bientott ?
If “yes,” give the approximate date(s)
Have you ever worked for bientott ?
If “yes,” When?
Have you any friends or relatives employed by bientott ?
If “yes,” Who?
SECOND PART
Please note, this section of the form will be detached and given to the Recruiting Manager. The Recruiting
Manager and the Interviewing Panel will have access only to information contained in this section.
PERSONAL INFORMATION
Family Name Title (Dr, Ms, etc)
Do you have a physical or mental disability as described as above?
Please do not attach a CV (or any other document) unless it has been requested as part of the
recruitment process; they will not be used to make selection decisions. This is to ensure that all
candidates are treated consistently.
PREVIOUS EMPLOYMENT
Please give details of your present or last employer
Name of Employer
Details of Salary.
Dates of Employment
Address (including postcode)
Email /Telephone Fax Number
Position and Responsibilities

4. Are there any reasonable adjustments in your existing or previous employment that Bientott needs to
consider should you be successful in this application?
EMPLOYMENT INTERESTS
Preferred Employment Type? Example :
Approximately how many hours a week do you want to work?
Are you willing to serve in any of the Bientott locations?
What are your salary expectations?
If married do you intend to relocate with your
family?
Yes No
Which other position would you intend to apply for?
NATIONALITY
Nationality at Birth
Present Nationality
Have you ever possessed any other nationality or citizenship? Yes No
If ‘Yes’ please specify:
PERSONAL QUALITIES AND OVERALL SUITABILITY FOR THE POST(S)
Please tell us briefly why you are interested in the position being applied for, what personal qualities
you bring and what makes you particularly suitable for the position?

5. YOUR SKILLS AND ABILITIES FOR THE JOB
State the skills and abilities you have which might be useful for the position you applied for:
We use this important section to help determine whether you should be invited to the selection stage.
You should show your skills by stating your abilities.
DECLARATION
I declare that the information I have provided in this application form is, to the best of my knowledge
and belief, correct and complete.
If you include any details that you know to be false or if you withhold relevant information, you may
render yourself liable to disqualification from the recruitment exercise or, if appointed, to dismissal.
If you submit your application electronically, typing your name will be taken as being as binding as
your signature.
APPLICANT’S SIGNATURE/NAME DATE
e for one year after completion of the recruitment exercise.
Bientott will use the information you provide in this form to process your application. If your application
is successful and you take up employment with bientott, his form will be kept on your personnel file
.
Third part possible if you are selected…
GOOD LUCK !