OLDER PEOPLE’S ACTION IN THE LOCALITY

Registered Charity No. 1131792

Company No. 06961204

Staff/Application Form

Please complete fully in black ink or type and return to the above address

Application for Post of Café Development Worker
Closing Date 02/04/2018
Name
Address
Telephone Day Evening
Do you possess a full driving licence?
Are you a car owner, or do you have full use of a car?
Please give details of any endorsements
HEALTH
OPAL is an Equal Opportunities employer. Is there anything concerning your medical history or state of health that would cause you difficulty in executing the Job Description associated with the above post?

EDUCATION AND TRAINING: Most recent first

From / To / Educational Establishment / Examinations Taken/Training Courses Attended / Results

EDUCATION AND TRAINING (continued)

From / To / Educational Establishment / Examinations Taken/Training Courses Attended / Results
EMPLOYMENT EXPERIENCE
Name and address of
present or last employer
Post Held
Grade/Salary
Date Appointed
Date of Leaving/Period of Notice
Duties and Responsibilities
If last employment please
Explain reason for leaving

PREVIOUS APPOINTMENTS Most recent first – continue overleaf if necessary

Employers Name and Address / Position and Duties / From / To

PREVIOUS APPOINTMENTS Most recent first – continued

Employers Name and Address / Position and Duties / From / To
ADDITIONAL INFORMATION
Please provide additional information in support of your application, including interests and voluntary work.
Please give as much information as possible.

Important Notice to Applicants: OPAL is obliged to ensure that all applications conform to the Criminal Records Bureau (CRB) Code of Practice. All applications are therefore subject to disclosure checks by the CRB, as well as satisfactory References before an Employee can be given a Contract of Employment and start work for OPAL

Do you have any previous convictions YES/NO
If yes please give details below: -
REFERENCES
Please give the names, addresses and telephone number of two people, one of whom should preferably be a recent employer. Please also state in what capacity you are known to them.
  1. …………………………………… 2. ……………………………………
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At what stage may we contact them: -
Before interview/After interview/At any stage (Please delete as appropriate)
DECLARATION
I declare that the information I have given on each sheet of this application form is correct to the best of my knowledge.
I understand that if I am offered the post, the information submitted in my application will form the basis of my Contract of Employment with OPAL and if it is subsequently discovered that I have wilfully given false information, I will be liable to immediate dismissal.
Signature …………………………………….. Date ………………………………
This form should be returned to: Ailsa Rhodes (CEO)
OPAL
Welcome In Community Centre
55 Bedford Drive
Leeds
LS16 6DJ

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