The Northampton Roman Catholic Diocese

Application Form

Contact Details
Full Name:
Address:
Telephone Numbers: / Home: / Mobile:
E-mail Address:
Application Details
Application for the position of:
How you heard of the Vacancy:
Please provide a summary of your relevant experiences/skills for this job role and why you are interested in this vacancy:
Please provide details of any previous or current employment with the Diocese:
Education
Please provide details of any qualifications or relevant training you may have received. If you have attached a CV to your application containing these details, you will not need to complete this section.
Establishment (e.g. school, training provider etc.) / Date / Subject/Course / Results (qualification/grade)
EmploymentHistory
To help us consider your application, please provide details of your employment history. If you have all the information requested below available on your CV, you do not need to fill in this section but should attach the CV to the application form. If you do not have a current CV, please provide details of your employment below.
Employer Name & Address / Dates from/to / Job Title/Summary of Duties / Reason for Leaving
Please provide a brief summary of any gaps in your employment history
Referees
It is our policy to request references from your previous two employers to confirm your employment history. If you would like to specify the name and contact details of a relevant manager from a previous employer, you can do so below. If you do not have a previous employer or only have one previous employer, please provide contact details of alternative referees which may include education establishments or a parish priest.
You can also provide referee details for an organisation or person where you have gained voluntary experience which is relevant for the role.Should the role require that you are a practicing Catholic, please ensure you provide details of your parish priest. We will not contact any employer for a reference before interview unless you consent below.
Name: / Name:
Contact Address: / Contact Address:
Tel No: / Tel No:
e-mail: / e-mail:
How long have you known this referee and in what capacity? / How long have you known this referee and in what capacity?
Can we request reference before interview? / Can we request reference before interview?
Additional Information
If you have any disabilities, please tell us if:
a)there are any reasonable adjustments we can make to assist you in your application
b)there are any reasonable adjustments we can make to the job itself to help you carry it out
c)You require assistance to attend an interview
Do you require a work permit to work in the UK. Yes / No
if so please give details
Declaration
In accordance with the Data Protection Act 1998, by signing and returning this application form I consent to the Diocese holding the information I provide to them both manually and in electronic form, for the purpose of this or any subsequent application of employment.
I understand that any offer of employment made by the Diocese would be subject to the receipt of references to the satisfaction of the Diocese and being medically fit to carry out the role which is offered.
I declare that all the information I provide in application for a role is true to the best of my knowledge and belief. I understand that any false entry or omission of facts may be sufficient cause for withdrawal of an offer, or if employed, render the contract of employment void.
Signed: / Dated:
Print Name: