SHELL PETROLEUM DEVELOPMENT COMPANY

The company of Opportunity

APPLICATION FORM PLEASE READ CAREFULLY BEFORE FILLING 1. Salaries are paid by direct transfer into an individual bank account or otherwise instructed. 2. All wages are subject to PAYEE and National Insurance if applicable. 3. 2 passport photographs will be required prior to commencement of any position offered.

Forename Surname & Title (Mr/Mrs./Miss/Ms/Other) Address

Postcode Telephone number: Mobile E-mail address Have you ever been convicted of a criminal offence? YES /NO Is any criminal prosecution pending? If yes please give dates and details YES/NO

SHELL PETROLEUM DEVELOPMENT COMPANY

The company of Opportunity

Have you any health problems that could affect your ability to work? (Please give details)

Please give brief details of any training or work experience you may have: ____________________________________________________________________________ _______ ____________________________________________________________________________ Please provide below any additional information that you feel is relevant for your application:

Please indicate whether you have any other work commitments:

Are you able to commit to working under pressure?

YES/NO

Have you previously worked anywhere before? If yes, please give a detailed description of the nature?

Are you willing to relocate to any of our office within the United Kingdom to resume work as soon as possible if employed? YES/ NO

SHELL PETROLEUM DEVELOPMENT COMPANY

The company of Opportunity

Please circle what identification documentation you can provide e.g.: Birth Certificate National Identity Card / Passport Drivers Licence Expiry Date: _____________

Monitoring information Date of Birth . *Male *Female *Nationality .

References: Please give the names, address and telephone number of two referees, one of which should have a professional relationship the other to provide a character reference, Name.. . Tel no. Name. .. Tel no..

I confirm that the information I have given is complete and correct. I understand that any false, misleading or undisclosed information could lead to my employment being terminated should my application be successful.

SHELL PETROLEUM DEVELOPMENT COMPANY

The company of Opportunity

Signed

Date