13 Elliott’s Place London EC1V 8AG

Confidential Job Application Form

NOTES

1.  It is strongly recommended that you read all enclosures before completing the application form. The information you provide will be the only material used in deciding if you should be interviewed. Applicants that do not address the requirements specified in the person specification will not be shortlisted

2.  Curriculum vitae are not acceptable.

3.  Applications received after the closing date will not be considered.

4.  Completed applications should be emailed to

JOB DETAILS
Job Title: / Closing Date:
How did you hear about this vacancy?
PERSONAL DETAILS
Surname / First Name(s) / Mr/Mrs/Miss/Ms
Address

Post Code
National Insurance No:
Home Telephone No: / Work Telephone No:
Mobile Telephone No: / Email Address:
Date Available for Employment:
Do you require a work permit to take up employment in the UK?
[ ] Yes [ ] No
If you are successful you will be required to provide evidence prior to your appointment.

Continued overleaf

EDUCATION (FROM AGE 11) AND FURTHER EDUCATION
(You may continue on a separate sheet if necessary)
Name of school, College, University etc / From / To / Qualifications and levels obtained

Continued overleaf

ADDITIONAL QUALIFICATIONS AND WORK-RELATED TRAINING
(including membership of professional bodies) (You may continue on a separate sheet if necessary)
Course Title / Subjects Covered / Dates / Qualifications and levels obtained

Continued overleaf

EMPLOYMENT HISTORY (You may continue on a separate sheet if necessary)
Please give full details of your previous employment, starting with the most recent. Please also explain any gaps in employment.
Period of Employment / Employer Name & Address / Job Title & Description of Responsibilities & Duties / Salary Per Annum / Reason for Leaving

Continued overleaf

PERSONAL STATEMENT
Please provide a statement in support of your application. You must relate the job description and person specification information to this personal statement.
.
(Please continue on a separate sheet, if necessary)
MEDICAL INFORMATION
Have you suffered any serious illness or accident in the last 5 years?
Please Tick [ ] Yes [ ] No / Are you registered Disabled?
Please Tick [ ] Yes [ ] No
If yes, please give details
REHABILITATION OF OFFENDERS ACT 1974
Any information given will be considered only in relation to the particular post for which you are applying.
·  If you have any criminal convictions which are “NOT SPENT”, you must disclose those convictions.
·  If you are applying for an “EXEMPT POST”, you must disclose all criminal convictions regardless of the nature of the sentence or the length of time of the conviction. Exempt posts are any position with access to under 18s, over 65s or vulnerable people of any age.
Have you any criminal conviction(s) or police cautions? [ ] Yes [ ] No
If you answer is “Yes” please provide full details of the offence(s), conviction(s), and caution(s) and return them in a sealed envelope along with your application form. If you are not selected for this post, the details will be returned to you.
If your work relates to you coming into contact with the under 18s, over 65s or vulnerable people of any age, a DBS check will be undertaken.
Applicants should note that providing false information to obtain employment is a criminal offence (S16 Theft Act)
EQUAL OPPORTUNITIES POLICY
This company is an Equal Opportunity Employer. All decisions on recruitment are based solely on the merits and abilities of each applicant, regardless of gender, sexual orientation, marital status, religion, race, ethnic origin or disability.
DATA PROTECTION ACT 1998
The company adheres to the Data Protection Act 1998.
No information shall be given out without your consent.
Unsuccessful applications will be securely shredded after three months of the closing date.
REFERENCES
Please give two referees, one from your present (or last) employer the other from a previous employer. They will not be contacted without your permission. (School/College leavers – if you are unable to give an employer, please give the name and address of two people who are able to supply a character reference – not relatives)
Name / Name
Position Held / Position Held
Company/Organisation / Company/Organisation
Address / Address
Tel & Fax Nos. / Tel & Fax Nos.
How long have you known this person and in what capacity? / How long have you known this person and in what capacity?
May we contact him/her prior to the interview?
Yes No / May we contact him/her prior to the interview?
Yes No
APPLICANT’S STATEMENT
I confirm that the above information is correct and understand that any false details given may result in my dismissal.
Signature ……………………………………………. Date ……………………………