Thames Valley Partnership
Townhill Barn, Dorton Road, Chilton,Aylesbury, Buckinghamshire HP18 9NA /
Application for appointment as: Restorative Justice Manager
Closing date for applications: Friday 5th May 2017 at 5pm
1. Applicant
Surname:
Forenames and title:
Address:
Tel No (home)
Tel No (day time):
Tel No (mobile):
E-mail address: / …………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
………………………………………………………………………………..
………………………………………………………………………………..
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
2. Referees
Please give names and addresses of two referees. / 1. ……………………………………………………………………………..
………………………………………………………………………………..
…………………………………………………………………………………
2. ..……………………………………………………………………………
…………………………………………………………………………………
…………………………………………………………………………………
3. How did you learn of this vacancy? / …………………………………………………………………………………
………………………………………………………………………………….
4. Education and Professional Qualifications
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………..
5. Please give details of your present and relevant past employment:
If you do not wish your employer to be contacted in the early stages, place an ‘X’ here below.
Name and full postal address of employer / Capacity in which employed / Dates employed
From To
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
……………………………………………… / ……………………………………………. / …………. / ………….
6. Present salary or wage ………………………………………………………………………………………….
7. Amount of notice required to terminate present employment: …………………………………..
8. Please give details of relevant experience and skills (refer to Job Description and Person Specification) Please restrict to no more than 2 sides of A4.
9. Please write up to 500 words in support of your application
10. Every section of this form must be completed.
I here by declare that all of the statements made by me are true in every respect. I enclose my curriculum vitae.
Date: ………………………………………… Signature: …………………………………………………..
This form should be returned electronically to:
Or by post - for the attention of:
Patsy Townsend
Director
Thames Valley Partnership
Townhill Barn
Dorton Road
Chilton
Aylesbury
Buckinghamshire HP18 9NA / For official use only