CONFIDENTIAL

Application for Employment Manchester Action on Street Health

94-96 Fairfield Street

Manchester

M1 2WR

Please complete this form and email to or return to the above address by noon 26th April 2017.
Application for the post of Transform Project Administrator

Personal details

Name of applicant
Address of applicant
Telephone contact number
Email address

Employment

Name and address of last or current employer:
Telephone contact number:
Job title:
Salary details:
Dates employed / from: / to:
Give a brief description of your duties:
Employment history:
Employers: / Post held and main duties: / Dates:
Give details and dates of any voluntary work you have done or relevant life experience:
Education and TrainingPlease provide details of any qualifications and/or training courses attended relevant to the post and the dates obtained.
Please tell us how you meet the Person Specification for this post?
Describe how you think you meet each point on the specification

Other comments or relevant information that would support your application.

Please give names and addresses of two referees who can speak for your competence to fulfil the requirements of the post. References will only be taken up for shortlisted applicants.
May we contact your present employer prior to interview?
Yes / No
Referee 1: Present or last employer
/ Referee 2 :
Name : / Name :
Address : / Address :
Telephone contact no. : / Telephone contact no. :
Occupation : / Occupation :
Relationship to you : / Relationship to you :
email : / email :
If you are a non-EU citizen do you have a UK work permit? /
YES
/ NO
APPLICANTS DECLARATION
I declare that to the best of my knowledge and belief the information I have given on the application form is true. I confirm to the best of my knowledge there are no medical or other reasons, which would prevent me from undertaking the duties of this post. I understand that to have knowingly given false information could lead to the withdrawal of any offer of employment or may result in dismissal if employment has commenced.
Signature: ……………………………………………. Date: …………………………………

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