Out Of The Box – Action day on Disability, Event Manager (March 2017)
Application Form
Please do not send any other documents. All relevant details should be entered on this form using continuation sheets if necessary.
Post applied for: Out Of The Box – Action day on Disability, Event Manager
Section One
APPLICANT DETAILS
Surname:
/Forename(s):
/Address: /
Postcode: /
Telephone Home: /
Mobile: /
Work: /
Are you happy for us to use this number? Y N
Email: /
Section Two
EDUCATION, COURSES AND TRAINING
Further/Higher Education
Name and address of establishment:
/Dates:
/Qualifications obtained:
Courses and TrainingPlease list below any other courses taken that you feel are relevant to the job you are applying for, the type of establishment attended and the qualifications obtained.
Establishment type and address:
/Dates:
/ Courses attended orQualifications obtained:
Please continue on a separate sheet if necessarySection Three
PREVIOUS WORK EXPERIENCE (paid and unpaid)
Please begin with your most recent job and work backwards. Please account for any gaps (you may wish to explain these more fully in Section Four). Periods out of paid work are not a disadvantage.Job Title and
Employer:
/Dates:
/Outline of duties:
/Reason for leaving:
Please continue on a separate sheet if necessary
Section Four
STATEMENT IN SUPPORT OF YOUR APPLICATIONPlease detail below why you are applying for this post and the qualifications, skills, experience and personal qualities you have which you believe make you suitable for the post. Mention also any facts about yourself (eg voluntary work, life experience) not stated elsewhere which you wish to draw to our attention. In preparing this statement you should consider very carefully the essential criteria for this post.
Please continue on a separate sheet if necessary
Section Five
ADDITIONAL PERSONAL DATA
Do you hold a full Driving Licence? /For how long? /
Do you consider yourself to have a disability? /
You are not obliged to answer the above question but if you are a person with a disability and you meet the essential criteria you will automatically be offered an interview.
Is there anything specific to your personal circumstances which you would like us to know? /
Section Six
REFEREES
Please give the name of two people who will be prepared to act as a referee. One of these should be your current or most recent employer.
Name:
/Name:
Address: /Address:
Position & Relationship to you: /Position & Relationship to you:
Telephone Number: /Telephone Number:
Can referee be contacted prior to interview? Yes/ No /Can referee be contacted prior to interview? Yes/ No
Please send your completed application form and equal opportunities monitoring form to:
Carousel
Community Base
113 – 117 Queens Road
Brighton BN1 3XG
Or email to
Closing date for receipt of applications:
Equal Opportunities Monitoring Form
This form helps us to monitor and evaluate our Equal Opportunities Policy. It will be detached from the application form and will not be used as part of the short-listing process.
If you do not wish to complete this form, it will in no way prejudice your application.
Position Applied for: / Office CoordinatorGender
Male / FemaleAge
Under 18 / 18 – 25 / 26-40 / 41-55 / 55-70 / Over 71Ethnic Origin
White British
/ Black or Black British African / White and Black African / Asian or Asian British Pakistani
/ Chinese
White Irish
/ Black or Black British Caribbean
/ White and Black Caribbean
/ Asian or Asian British Indian / Any Other Asian Background
Any Other White Background / Any Other Black Background / Any Other Mixed Background / Asian or Asian British Bangladeshi / White and Asian
Any Other Ethnic Group
Sexual Orientation
Heterosexual / Gay / Lesbian / Bi-sexual
Religion
Christian / Hinduism / Islam (Muslim) / Buddhism / Sikhism
Judaism / Zoroastrian
(Parsi) / Other / No religion / Do not wish to answer
Disability Status
Are you a person with a disability? / Are you registered disabled?
Where/How did you hear about the project?
Thank you for completing this form
Page 6 of 6