Personal details:
Title: / Full Name:
Address:
Postcode:
Tel no day: / Tel no eve:
Mobile: / Email:
National Insurance No: / Country of Citizenship:
If your citizenship is not British do you have a valid work permit?: Yes / No/ na
(PLEASE ENCLOSE A PHOTOCOPY OF YOUR WORK VISA)
Education:
Please give details of your education and training since the age of 11
Name of School/College/University / From / To / Exams passedEducation cont.:
Name of School/College/University / From / To / Exams passed
Employment:
Name of current employer:
Address:
Telephone Number:
Present Position Held:
Current Salary:
Brief Description of Duties:
Date Employment Commenced:
Period of Notice Required for Leaving:
Employment cont.
Please give details of previous employment in chronological order
Employer Name & Address / From/To / Job Title & Duties / Salary / Reason for leavingHealth:
Please state the number of days you have been absent from work due to illness In the PAST 12 MONTHS.
Have you had any period of serious illness in the past 5 years which has given rise to your being absent from work for more than five consecutive days?
Please give any details of any medical disability?
Are you registered disabled? Yes / No
Public Duties
Please give details of any public service duties you are required to perform
(eg. JP, Member of Local Authority etc.)
Criminal Convictions
Have you ever been convicted of a criminal offence Yes/No
If YES and we invite you for interview, we will write to you asking you to provide details. This information will be treated with strict confidence and will only be seen by those who need to see it as part of the recruitment process.
If you are successful in your application to the Friendly Almshouses, our offer of appointment will be subject to pre-employment checks. This will include a requirement for you to apply for an Enhanced Disclosure through the Criminal Records Bureau. A copy of our Code of Practice on using this process is available on request. If the Criminal Records Bureau’s Disclosure finds that you have a criminal record, this will not automatically mean we will not let you join our organisation. Instead we will consider that record very carefully in accordance with our policy on the Recruitment of Ex-Offenders, a copy of which is available.
Supporting Statement
Please tell us why you think you are suitable for the job by showing how you meet the requirements of the Person Specification. Make sure you address all the points listed in the Person Specification. Continue on a separate sheet if necessary but remember to put your name on each sheet.
Referees
Please give the names of two referees. One should be your present employer.
Title: Mr/Mrs/Miss/Ms / Title: Mr/Mrs/Miss/Ms
Name: / Name:
Address:
Postcode: / Address:
Postcode:
Tel no: / Tel no:
Email address: / Email address:
Position: / Position:
How long have they known you? / How long have they known you?
Please state whether we can contact them before interview: Yes/No
Declaration
DECLARATION
If you give information which you know is false, this may lead to your application being rejected, or if you are appointed, to your dismissal.
I declare that the information I have given is to the best of my knowledge true and complete.
Signature : Date :
Please return 3 completed forms, marked CONFIDENTIAL to:
Mrs Hilary Parsons, Vice-Chairman
The Friendly Almshouses - 167 Stockwell Park Road, London SW9 0TL
Closing Date: Monday 30th April 2012 at 5 pm.
Applications received after this date cannot be considered.