6-9 Manor Gardens

6-9 Manor Gardens

London

N7 6LA

020 7263 1301

Application form

Please complete all sections of this form electronically. We do not accept curriculum vitae in place of completed application forms. Please return the completed application form to or by post to: The Baobab Centre for Young Survivors in Exile, 6 Manor Gardens, London N7 6LA

Job applied for:

DELETE/TICK WHERE APPLICABLE

Your Personal Details
Ms/Miss/Mrs/Mr Surname
(other please state)
Forename(s)
Address (including post code)
Home phone number
Mobile number
Email address
Work phone number
Do you require a work permit to work in the UK? / ❑ Yes ❑ No If ‘Yes’, do you have a valid permit? ❑ Yes ❑ No
Your Current or Most Recent Employment
Job title
Name of employer
Address of employer
Nature of the business
Your main duties and responsibilities
Your Current or Most Recent Employment
Start date
Present or most recent salary
Part-/full-time and hours worked
Date you left (if applicable)
Reason for leaving (if applicable)
Length of notice required (if applicable)
Your Previous Employment
Full history including any gaps in employment and reasons – continue on a separate sheet if necessary
Dates
From: To: / Position held / Employer’s name / Nature of business / Reason for leaving
Your Education, Training and Personal Development
TERTIARY EDUCATION as well as professional qualifications
College/University / From – to / Examination results (subject, level, grade)
SECONDARY EDUCATION
School / From – to / Examination results (subject, level, grade)
OTHER TRAINING COURSES / From – to / Examination results if relevant (subject, level, grade)
MEMBERSHIP OF PROFESSIONAL BODIES
Your References
All offers of employment are subject to the receipt of two satisfactory references. Please give the details of two referees, at least one of which should be your current employer or last employer if you are currently unemployed, who we can write to confidentially.
If you cannot provide two employer referees, please provide the name(s) of people who know you in a professional capacity e.g. an institute of education (school, college etc). Personal references from friends or family are not acceptable.
Name: / Name:
Relationship: / Relationship:
Address: / Address:
Telephone: / Telephone:
E-mail: / E-mail:

Note: we will only contact your referees after interview and with your permission

Supporting Information
Please use this section to tell us how you meet each of the criteria in both the job description and person specification, providing evidence/examples. We use the criteria in the person specification to decide who to shortlist for interview. Please continue on separate sheets if necessary. Try to be concise in your responses.
Additional Information
Do you speak any languages other than English? Yes  No 
If yes please specify:
If you have a disability please tell us about any adjustments we may need to make to assist you at interview:
Please tell us where you saw the post advertised:
The Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 2001
Baobabis committed to safeguarding and promoting the welfare of children and young people and expects all staff to share this commitment. An enhanced CRB check is required for all successful applicants
If you have been convicted of any offence(s), or if there are proceedings pending against you, please give details.
The post you are applying for is covered by the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 2001. This means that applicants must declare all convictions, including cautions, for any offence(s) which for other purposes are ‘spent’ under the provisions of the Act. Failure to disclose any previous convictions (including cautions) could result in dismissal should it be subsequently discovered. Any information given, either when returning this application form or at interview, will be entirely confidential and will be considered only in relation to this application.
Date / Type of Offence / Sentence/Fine Imposed / Comments
Data Protection Statement
I certify that all the information provided in this application form, together with any other information that I may provide during the course of my application, is true and accurate to the best of my knowledge and belief, I understand and agree that:
1. any information I provide may be verified through personal or written contact in whatever manner is considered appropriate by the Baobab Centre for Young Survivors in Exile and that any false or misleading statement may be sufficient cause for rejection or, if appointed, dismissal; and
2. the information that I have provided in this application form and any other personal data (including sensitive personal data) that I may provide during the application process or any period of employment with the Baobab Centre for Young Survivors in Exile may be transferred to, held (in manual or electronic form) and used by the Baobab Centre for Young Survivors in Exile and/or carefully vetted third parties who may process personal data on behalf of the Baobab Centre for Young Survivors in Exile, for all purposes in connection with personnel and/or administrative matters including, without limitation, management planning or forecasting, and I expressly consent to such processing.
Signed: Date:

Thank you for your interest in the Baobab Centre for Young Survivors in Exile.

Please now return this form together with the completed Equal Opportunities Monitoring Form(see below) by email to:

or by post to:

Baobab Centre, 6-9 Manor Gardens, London N7 6LA

Equal opportunities Confidential

The Baobab Centre monitors applications through to selection to ensure its equal opportunities policies are working properly. We particularly welcome applications from people with disabilities and people from ethnic minority groups. In order to monitor the effectiveness of this policy, all applicants are asked to complete this form. This form will be retained by the Operations Manager and will not be used in the selection process, or seen by members of the panel.

Name Job applied for
What is your gender identity:
Man (including trans man) / Woman (including trans woman) / Other gender identity
Date of birth
Where did you see this post advertised?
Social Media: Twitter/LinkedIn (Delete as appropriate)
Website:

Employment status(this section must be completed)

Are you a national of one of the European Economic Area countries andable to work without a visa in the UK? YES / NO
If NO, do you have a visa allowing you the unrestricted right to work
in the UK? YES / NO
Note: We will need to see originals of relevant documentation prior to appointment

Criminal convictions(this section must be completed)

Do you have a current/pending conviction? YES / NO
If YES, please give details
If the post is exempt from the Rehabilitation of Offenders Act 1974 you will be notified and required to complete a CRB check. If this has been indentified please declare if you have any spent convictions along with the details here:

Disability

Do you consider yourself to have a disability/impairment/condition covered by the Equality Act 2010*? YES / NO
Is there anything we need to know in order to offer you a fair selection process at interview? If YES, please give details below: YES / NO
Should you be successful in your appointment, please can you state below any specific arrangements that we would need to make for you to take up the role:
* The Equalities Act 2010 defines disability as: ‘a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities which has lasted or is likely to last for at least 12 months’.

Ethnicity(NB this is not a question about your nationality or place of birth)

White / British / Irish
Any other White background (please specify)
Mixed / White and Black Caribbean / White and Asian
White and Black African
Any other Mixed background (please specify)
Asian or Asian / Indian / Pakistani / Bangladeshi
British
Any other Asian background (please specify)
Black or Black / Caribbean / African
British
Any other Black background (please specify)
Chinese or other / Chinese
ethnic group
Any other ethnic background (please specify)

Sexuality

Do you consider yourself to be within any of the following categories:
Gay Lesbian Bi-sexual Heterosexual
Decline to answer questions on sexuality

Belief

Church of England Catholic Protestant Quaker
Christian other: please specify
Muslim Hindu Sikh Buddhist Jewish
No religion
Other religion: please specify
Other belief/non belief: please specify
Decline to answer

Data protection: Information from this application may be processed for purposes registered by The Baobab Centre under the Data Protection Act 1998. Individuals have, on written request the right of access to personal data held about them.

I hereby give my consent to the Baobab Centre processing the data supplied in this form for the purpose of recruitment and selection.

SignatureDate