APPLICATION FOR EMPLOYMENT

Please complete this form in full - CVs are not acceptable

POST APPLIED FOR:
PERSONAL DETAILS
SURNAME: INITIALS:
ADDRESS:
POST CODE:
TELEPHONE: Home: Work: Mobile:
EMAIL:
May we contact you at work? YES / NO

PRESENT OR MOST RECENT EMPLOYER

NAME
ADDRESS:
POSTCODE
YOUR JOB TITLE:
DATES OF EMPLOYMENT: From: To:
LENGTH OF NOTICE REQUIRED:
REASON FOR LEAVING:

PREVIOUS EMPLOYMENT

NAME AND NATURE OF BUSINESS / POST HELD / DATES / REASON FOR LEAVING
From / To

EDUCATION

WHERE
(eg School, FE College, University etc) / COURSE DETAILS / QUALIFICATIONS OBTAINED

OTHER TRAINING including short courses.

TRAINING ORGANISATION / COURSE NAME AND BRIEF DETAILS / DATE(S)
SUPPORTING INFORMATION (Please refer to Guidance Notes)
Please continue over
Supporting Information continued:
Please continue on another sheet if necessary.

HEALTH AND DISABILITY

The Disability Discrimination Act (DDA) defines a disabled person as “someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities”. If you have such a disability, please give details:
If you are invited for an interview, are there any adjustments we would need to make (eg physical access, personal support)?
How much sickness absence have you had over the past two years? / Number of episodes / Total days off
How would you describe your current state of health?
Do you have any health problems that a prospective employer should be aware of? / YES / NO
If yes, please give details:
REFERENCES (please refer to Guidance Notes)
NAME:
ADDRESS:
POSTCODE
TEL NO:
EMAIL
JOB TITLE / NAME:
ADDRESS:
POSTCODE
TEL NO:
EMAIL
JOB TITLE
EMPLOYMENT OF EX-OFFENDERS
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) and associated Order. Applicants are not entitled to withhold information about convictions including convictions which, for other purposes, are “spent” under the conditions of the Act.
If you are invited to an interview, you will be asked to declare any convictions, including “spent” convictions, before the interview. Failure to disclose such convictions could result in the withdrawal of an offer of employment or later disciplinary action.
If you are appointed to the post you will be asked to complete a Disclosure and Barring Service form requesting an Enhanced Disclosure of any criminal record you may have. Please see the enclosed ‘Shortlisted Candidate Information Sheet’ for further information.
Having convictions will not necessarily bar you from employment. This will depend on the circumstances and background of the offence(s).

DATA PROTECTION

The information you have provided will be handled and processed in accordance with the Data Protection Act 1998. If you are appointed, the information will form part of your personnel record and may be used for management and monitoring purposes.
DECLARATION
Please sign and date this declaration before returning this Application Form. If you send the form by email you will be required to sign it if and when you are interviewed.
I declare that the information given on this form is true and complete to the best of my knowledge and belief and can be treated as part of any subsequent contract of employment. I understand that any false information or deliberate omission may result in rejection or, if appointed, lead to later disciplinary action.
Signed: Date:

EQUAL OPPORTUNITIES MONITORING FORM

(Please see Guidance Notes and Equal Opportunities Policy

for more information.)

Title (Mr / Mrs / Miss / Ms / Dr / etc)
Surname / First name
Date of Birth / Gender
ETHNIC ORIGIN
White / Black
British / Caribbean
Irish / African
Other white (describe below) / Other black (describe below)
Asian or British Asian / Mixed
Indian / White & black Caribbean
Pakistani / White and black African
Bangladeshi / White and Asian
Other Asian (describe below) / Other mixed (describe below)
Chinese or other ethnic group / Other
Chinese / Any other (describe below)
Description
PHYSICAL DISABILITY AND MENTAL HEALTH
Do you consider yourself to have a physical or sensory disability? / YES / NO
Do you consider yourself to have a Learning Disability? / YES / NO
Do you consider yourself to have a disability relating to your mental health? / YES / NO

3