Office Use Only - Reference Number RTO 0215

office use only - reference number RTO 0215

APPLICATION FOR EMPLOYMENT

Please read the Job Description and Person Specification carefully before completing this form. Please use black text.

Shortlisting will be based solely on the basis of the information you provide in this application form.

Application for:Research and Training Officer

•Section 1 - Personal Details

Preferred Title (Miss/ Mr / Mrs) ______

First/Given Name______Family Name______

Address______Phone - Day______

______- Evening ______

______- Mobile ______

Post Code______

Do you have any restrictions on your right to work and live in the United Kingdom: YES / NO

If yes, please give details:

•Section 2 - References

Please give the names, addresses and ‘phone numbers of two referees, one of whom must be your present or most recent employer (paid or voluntary work). The other may be a previous employer, or any other person who knows you well in a professional capacity.

1.Name______2.Name______

Address______Address______

______

Post Code______Post Code______

Phone - Day______Phone - Day______

Phone - Eve.______Phone - Eve.______

Relationship______Relationship______

Tick boxes if we can we contact Referee 1 and/or Referee 2 before interview.

Please state the period of notice you are required to give to your employer: ______

•Section 3a - Formal Education & Training

Please tell us about your formal education (17+) and any vocational/professional qualifications and training.

From / To / Course/Qualification/Grade / Institution

•Section 3b - Other Education, Training & Professional Development

Please tell us about any other relevant courses or training that you have attended.

From / To / Course/Training/Grade / Institution/Provider

•Section 4 - Employment History(in reverse chronological order)

Tell us about your employment history, giving your current/most recent position first. Please ensure that you provide all the information requested.

From / To / Position
Organisation
Salary & Benefits
Reason for Leaving / Key Responsibilities

•Section 4 cont’d - Employment History(in reverse chronological order)

From / To / Position
Organisation
Salary & Benefits
Reason for Leaving / Key Responsibilities

•Section 5a - Experience, Skills & Achievements

Provide concise and specific examples of relevant achievement and responsibility in relation to the job description and person specification. It is in your interest to address all the essential requirements listed in the Person Specification.

•Section 5a cont’d - Experience, Skills & Achievements

•Section 5b -Briefly outline what inspires you about the values and purpose of Chance UK and why you seek to be our Research and Training Officer.

•Section 6 - Other Information

Please use this space to tell us anything else that you feel may be useful to your application, bearing in mind the requirements of the job. Also, tell us anything that you feel we ought to know about any special needs during interview or at work, e.g. disability. Completing this section is optional.

Disclosure
Chance UK is a Disclosure & Barring Sevice (DBS) registered organisation. All job applicants must complete an enhanced disclosure records check to ensure the safety of the children with whom we work. Please note that not ALL criminal convictions automatically preclude applicants from working for Chance UK. However, if you do have any listed convictions they must ALL be declared below:
Have you ever been convicted of a criminal offence? YES If yes, please supply full details below NO 

Declaration

I declare that the information I have provided on this form is true and accurate, and in particular that I have not omitted any material facts which may have a bearing on my application. I understand that any subsequent contract of employment with Chance UK will be made on the basis of the information I have provided. Furthermore, I understand that a false declaration that results in my appointment to Chance UK will render me liable to dismissal without notice.

Signed ______Date ______

If you are offered the position, we will confirm appointment upon receipt of satisfactory references

and an enhanced disclosure DBS check.

for office use only

ShortlistedYesNo

InterviewYes NoDate Time

Outcome:Offer Yes NoReserveYes (No. )No

Specific Needs:

Reference 1 Sent( ) Received ( )

Reference 2Sent( ) Received ( )

Offer Call Made( )Accept / Reject – Reason :

Offer LetterSent ( )

Acceptance LetterReceived( )

Notes:

1