STRICTLY

CONFIDENTIAL

/

APPLICATION FOR EMPLOYMENT

Please print clearly in black ink. Complete all sections. Sign and date the form.

Please do not submit CV’s. Application form only.

Position applied for:

1 PERSONAL DETAILS

Surname: / Forename(s):
Preferred name:
Contact Address:
Post Code:
Tel. No. (Home): Tel. No. (Work):
Tel. Mobile:
Email address:
Are you deemed as being ‘entitled’ or ‘entitled to work’ under the Control of Housing and Work (Jersey) 2012? Yes / No
2(a) EDUCATIONAL/PROFESSIONAL QUALIFICATIONS

Secondary Education

Qualification / Grade / Qualification / Grade
Further Education
Course, e.g.: GNVQ / NVQ/
Special Training/Languages
Diploma/Degree or equivalent / Dates
From/To / Course Title / Standard Attained
2(b) MEMBERSHIP OF PROFESSIONAL BODIES
3 (a) COMPETENCIES
Please give a brief account of any particular training, experience or skills you have relevant to the post. Specifically relate this to the competencies in the job description. (Continue on a separate sheet if necessary.)
3(b) ADDITIONAL INFORMATION
, Please detail any additional information which would support your application. (Continue on a separate sheet if necessary.)
4 DRIVING LICENCE
Do you hold a current driving licence? YES / NO

5 EMPLOYMENT HISTORY

Starting with your present post, list in reverse order every employment you have had. Please describe your last three jobs in detail so that we can compare your experience with the requirements of the job for which you are applying.
(a) Present or most recent employment
From
Month/Year / To

Month/Year

/ Title of Post:
Name and address of employer:
Number of employees
supervised by you:
Nature of business: / Period of notice:
Precise reasons for leaving or wishing to leave:
Description of your duties:
(b) Previous employment
From
Month/Year / To

Month/Year

/ Title of Post:
Name and address of employer:
Number of employees
supervised by you:
Nature of business:
Precise reasons for leaving:
Description of your duties:
(c) Previous employment
From
Month/Year / To

Month/Year

/ Title of Post:
Name and address of employer:
Number of employees
supervised by you:
Nature of business:
Precise reasons for leaving:
Description of your duties:
(d) Previous employment (If there is not sufficient space on the form, please continue on a separate sheet.)

Dates

From To /

Name and address of employer

/

Title of Post

6 (a) REFERENCES
Jersey Employment Trust reserves the right to approach your previous employers without your permission for a reference before offering employment. However, we will not approach your present employer prior to interview without your agreement. Referees should not be related to you.
* I do / do not wish my present employer to be contacted before interview. * Delete as appropriate
(b) An enhanced DBS check is required for this post at the offer of employment stage
Reference 1
Present Employer / Reference 2
Previous Employer
Name / Name
Address / Address
Post Code / Post Code
Tel. No: / Tel. No:
Email address: / Email address:
7SPECIAL REQUIREMENTS

Any special requirements if selected for interview? (e.g. disabled access)

DECLARATION

I hereby declare that the details shown are correct and complete to the best of my knowledge. I understand that any false statements or the withholding of any relevant information may provide grounds for rejection of my application, or termination of my contract of employment. I understand that the Jersey Employment Trust – Workforce Solutions Ltd will process this application subject to the Data Protection (Jersey) Law 2005.
Applicant’s signature: …………………………………….. Date:………………………….
Please return your form to:
JERSEY EMPLOYMENT TRUST
THE OAKFIELDBUILDING
LA RUE DU FROID VENT
ST SAVIOUR
JE2 7LJ

Diversity and Equal Opportunities Monitoring Form

Jersey Employment Trust is committed to diversity and equal opportunities. This means that we shall treat all applicants and employees fairly and equally, irrespective of ethnic origin, sex, marital status, sexual orientation, age, religion or disability.

The information you provide here is confidential, and will be used for monitoring purposes only. It will not be seen by the short-listing or interview panels. Please return this form with your application to the address above.

Please tick all the boxes that apply to you:

Gender
Male
Female
Do not wish to answer
Age Group
Under 21
21- 30
31- 40
41- 50
51-60
61 +
Do not wish to answer
Disability / long-term health condition
Do you consider yourself to have a disability?
Yes
No
I do not wish to disclose this information
Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.
Physical impairment
Sensory impairment
Mental health condition
Learning disability
Brain injury
Visual impairment / Autistic Spectrum Condition
Hearing impairment
Long term health condition
Please specify……………………………..
Other(please specify)
………………………………
Ethnic Origin
White
British
Irish
Other European
Other………………………… / Asian
Asian British
Bangladeshi
Indian
Pakistani
Other……………………………..
Arab or Middle Eastern Descent
Arab
North African
Iraqi
Kurdish
Other…………………………….. / Black
African
Black British
Caribbean
Other……………………………..
Mixed race
White and Asian
White and Black African
White and Black Caribbean
White and Chinese
Other…………………………….. / Chinese
Chinese
Other……………………………..
Other
(please specify) ………………………………
Advertising and Publicity
Please tell us how you heard of this vacancy:
Recruitment Website
(please specify)……………………………………………………………………..
JET/Acorn Website
Jersey Evening Post
Word of Mouth
Other
(please specify)………………………………………………………………………

Personal Data

From time to time it may be necessary to process sensitive personal data for example, information relating to an individual’s ethnic origin for equal opportunity monitoring. By completing our Equal Opportunity and Diversity form you agree that the employer may retain and process sensitive personal data about you as the needs of the organisation require.