Completed Applications Should Be Returned To

APPLICATION FORM

Position applied for:

Personal Information
First name / Surname / Title
Address
Postcode / Email
Mobile / Telephone Home / Telephone Work
Declaration – I confirm that the information provided is correct. I understand that any information supplied that proves to be untrue, could lead to a withdrawal of offer and/or dismissal.
Signed ______Date ______

Completed applications should be returned to:

Education History
School / College or University / Dates / Qualification Gained
Your Current or Latest EMPLOYMENT
Please list in order (with the most recent first) the organisation/s you have worked for in full and/or part time employment including relevant voluntary or unpaid work. If not currently employed, list your most recent employer first
Dates / Name & Address of Employer / Job Title / Duties / Rate of Pay
Notice required:
EMPLOYMENT HISTORY (Please do not attach a CV)
Dates / Name & Address of Employer / Job Title / Duties / Rate of Pay
Supporting Statement -
With reference to the person specification and project description, please describe your suitability for the post. Up to two further sheets may be used.
IMMIGRATION – In order to comply with the Asylum and Immigration Act (1996) we must ensure that all new staff have the right to work in UK. Prior to an offer of employment, we will require evidence that you have permission to work in the United Kingdom and a copy will be retained. This will be treated as confidential and held under our Data Protection Policy and Confidentiality Policy.
Do you require a work permit to work in the UK?
 yes  no (tick one)
If yes, please give details: ______
Criminal Record – Please detail any criminal convictions. Except those ‘spent’ under the Rehabilitation Of Offenders Act 1974. If none, please state
Disclosure and Barring Service - As an organisation that works with vulnerable people and children, we are required to make enhanced checks with the DBS for all staff and volunteers. Please indicate whether you would be happy to comply with this.
 yes  no (tick one)
References –Please list 2 referees – one should be your current or last employer. References will only be taken up after the interview once a firm job offer is made.
Reference 1 / Reference 2
Name: / Name:
Address: / Address:
Email: / Email:
Daytime telephone: / Daytime telephone:
Job title: / Job title:
How known to you: / How known to you:

PLEASE RETURN TO

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