APPLICATION FOR THE POST OFCommunications & Development Officer
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PERSONAL INFORMATION
Surname: Click here to enter text.Forenames: Click here to enter text.
Home Address: Click here to enter text.
Telephone No.Home:Click here to enter text.Mobile: Click here to enter text.
Email:Click here to enter text.
EDUCATIONAL PROFESSIONAL QUALIFICATIONS:
Please list your secondary, further and/or higher educational and professional qualifications starting with the most recent. Please also list any relevant training courses and any qualifications gained.
Name & address of institution / Qualifications & resultsClick here to enter text. / Click here to enter text. /
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EMPLOYMENT INFORMATION
Please list all previous employment beginning with your present or most recent employment.
Name & Address of Employer / JobTitle / Duties & Achievements / Dates / Reason for Leaving / Salary
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Continue on a separate sheet if necessary
OTHER EXPERIENCE, INTERESTS & VOLUNTARY ACTIVITIES
All time since leaving full-time education should be accounted fore.g. unemployment, voluntary work, raising a family.
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SUPPORTING STATEMENT 500 – 1000 words
Please show what skills/qualities as described in the personal specification, you feel you would bring to this job and state why you are interested in this post. Please refer specifically to the skills, experience and personal specifications we seek in the job description.
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REFERENCES
Please give names and address of two people who may be approached to give a reference. One should be your present or most recent employer.
Name / Click here to enter text. / Name / Click here to enter text. /Position / Click here to enter text. / Position / Click here to enter text. /
Company / Click here to enter text. / Company / Click here to enter text. /
Address / Click here to enter text. / Address / Click here to enter text. /
Telephone No / Click here to enter text. / Telephone No / Click here to enter text. /
Email / Click here to enter text. / Email / Click here to enter text. /
Relationship to you / Click here to enter text. / Relationship to you / Click here to enter text. /
Because of the nature of the work for which you are applying this post is exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 (exemptions) order 1975. Applicants are therefore not entitled to withhold information about convictions which for other purposes are spent under the provision of the Act. In the event of employment any failure to disclose such convictions could result in dismissal.
The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website.
Have you been convicted of a criminal offence in the past?Choose an item.
If ‘yes’ please give details. Click here to enter text.
Are you aware of any physical, medical or related problem which would prejudice you undertaking this post? Choose an item.
If ‘yes’ this would need to be disclosed in confidence during the interview.
I declare that to the best of my knowledge, the information given on this application is true.
Signed:Click here to enter text.Date: Click here to enter text.
If you are completing this form electronically and are invited to interview, you will be required to sign your application form at that stage.
EQUAL OPPORTUNITIES INFORMATION
This information is for monitoring purposes only and will not be used in the selection process.
Post applied for: Click here to enter text.
Where did you see this post advertised? Click here to enter text.
Gender: Choose an item.
Age:Click here to enter text.
Health:
Do you have a health need or disability which requires special facilities in theworkplace?Choose an item.
If yes, please describe Click here to enter text.
Racial Group:
Please indicate which of the following racial groups you belong to:
(Classifications recommended by the CRE)
☐White British☐Black – other background
☐White Irish☐Bangladeshi
☐White – other background☐Chinese
☐White and Black Caribbean☐Indian
☐White and Black African☐Pakistani
☐White and Asian☐Any other Asian background
☐Any other mixed background☐Other ethnic origin
Please specify Click here to enter text.
☐Black – African☐Not stated
☐Black - Caribbean
Dependants:
Are you responsible for dependants?Choose an item.
By completing this Equal Opportunities Information form, I understand that I give my consent under the Data Protection Act 1998 for the information contained in this form to be processed in accordance with St Michael’s Fellowship’s policy for the purposes of equal opportunities monitoring.