Liverpool Lighthouse Ltd

CONFIDENTIAL

Liverpool Lighthouse is a Christian Organisation and Equal Opportunities Employer. This means that all applicants of voluntary work will be treated equally and the recruitment decision will not be influenced by any perceived prejudices in relation to the age profile, gender, disability, sexual orientation, religious belief, background or spoken accent.

Associate, placement and apprentices are required to conform, uphold and support the organisation christian ethos and abide by the company policies, procedures and good practice framework.

It is ESSENTIAL that applicants read this application form carefully,complete as fully as possible and return it as instructed at the end of the form.

Surname (block capitals) …………………………….Preferred Title ………………

Forename(s) ……………………………………. Date of birth ………………...

Address …………………………………………. Tel number ………………….

…………………………………………………… Mobile ……………………...

Post code ………………… Email address………………………………………

Please tick the appropriate boxes

GENDER MARITAL STATUS

Male Female Married Single

If divorced or separated please tick this box

AGERANGE

15-3030-4545-5050-6565-75+75

What skills, qualification or any life experience, knowledge or other interestsyou would consider relevant to offer to our company?

We have a range of areas as follows and welcome a range of skills and knowledge, but we need to review areas for voluntary work and make sure they cover current needs. Please indicate your area of interest belo, you may choose few as appropriate.

We have a range of areas as follows and welcome a range of skills, but we need to review areas for voluntary work and make sure they cover current needs. Please indicate

Liverpool Lighthouse takes Safeguarding seriously, it is committed to safeguarding & promoting the welfare of children and expect all staff/volunteers to share thiscommitment. Please note that all successful candidates who may work with Children and / or Vulnerable Adults will be subject to a criminal conviction check through the Disclosure and Barring Service.

The Rehabilitation of Offenders Act 1974 allows people who have been convicted of certain criminal offences to regard their conviction as ‘spent’ after a period of years. This means that, in general, no reference need to be madethe conviction or any circumstances relating to it. Because of the nature of voluntary work for which you are applying, however, this post may be excepted from the provision of the Act. You are therefore required not to withhold information about convictions which for other purpose are ‘spent’ under the provision of the Act. In the event of recruitment as a volunteer,we reserve the right to withdraw the offer at any time in case of failure to disclose such convictions or our DBS check reveals any misleading information after the induction process. Any information given will be considered only in relation to applicants to become a volunteer where such an exception is appropriate. We reserve the right to withdraw the offer at any time if our DBS check reveals any misleading or non-disclosed information afterward.

I have read and understood the above and have the following convictions to disclose:

I certify that, to the best of my knowledge, the information that I have completed on this application form is true and correct and is a true record of my personal situation.

Signature:Date:

Please give the names and addresses of 2 people from whom references may be sought concerning your application.

One of the referees should preferably be a past employer or an assessor with the other being a character reference.

Name ______Name ______

Address ______Address______

Tel no ______Tel no ______

Email address ______Email address ______

Occupation ______Occupation ______

I understand that Liverpool Lighthouse is a non smoking organisation. I will use good sense and responsibility to comply with the non-smoking policy and will follow appropriate “no-smoking” signs displayed inside and outside its premises.

Signature______Date______

How did you hear about Liverpool Lighthouse Ltd?

______

Thank you very much for applying to be a part of our group of volunteers; we will be in contact with you as soon as possible.

Ref 1 / Requested / Ref 2 / Requested
Ref 1 / Received / Ref 2 / Received

When completed this form should bereturned by post or hand to:

Petronelle Moanda

Liverpool Lighthouse

Oakfield Road

Liverpool

L4 0UF

or submitted electronically to:

or

Ver. 3/14Liverpool Lighthouse, Oakfield Road, Anfield, Liverpool L4 0UF, Tel: 0151 476 2342