FAMILY MATTERS INSTITUTE

APPLICATION FORM

(Please complete this form in block capitals)

Position: / Location:Moggerhanger Park
Personal Details
Family Name: / Title: ( Mr/Ms/Mrs/Miss )
Given Names: / Email Address:
Address:
Home Tel No: / Mobile Tel No:
Education
From / To / School/College/University / Examinations Taken / Results Obtained
Professional Qualifications
From / To / Professional Body/Training School / Qualification / Membership Number
RecentTraining or Courses
From / To / Establishment Attended / Type of training/course
Present or Most Recent Employment
Employers Name and Address: / Position held:
Date Appointed:
Date Left:
Telephone Number: / Present Salary:
Nature of Business: / Notice Period:
Summary of Duties and Responsibilities:
Reason for Leaving/ Wanting to Leave:
Previous Appointments (Most recent first)
From / To / Employer’s Name and Address / Job title and brief summary key responsibilities / Reason for Leaving
Please continue on a separate sheet if necessary.
SUPPORTING INFORMATION
Please read of the Job Specification thoroughly before completing this section. Please use this section to give any additional information in support of your application and let us know why you think you should be considered for this post including examples of your achievements, skills and experience.
Rehabilitation of Offenders Act
Please note any criminal convictions except those ‘spent’ under the Rehabilitation of Offenders Act 1974.Please note that most crimes against children and vulnerable people are never spent and therefore must be disclosed. If none please state.
Asylum and Immigration Act
Are there any restrictions on you taking up employment in the UK? Yes/No (If yes please provide details)
Driving Licence
Do you hold a full, valid Driving Licence? Yes/No / Details of any current endorsements:
References
Please give the addresses and contact details for your previous two employers. Referees must not be related to you. Please say if you would prefer us not to contact your current employer prior to interview (this may delay any job offer, therefore please try and select at least one referee we can contact prior to interview).References will only be taken up with your permission.
Name: / Name:
Job Title: / Job Title:
Address: / Address:
Work Tel No: / Work Tel No:
Email: / Email:
Can we contact this reference prior to interview? / Can we contact this reference prior to interview?
How did you hear about this vacancy? / Dates not available for interview:
Declaration (Please read carefully before signing this application)
  1. I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.
  2. I agree that the organisation reserves the right to require me to undergo a medical examination.

Signed: / Date:
Please return this form to:
Please submit this application electronically to to arrive no later than the application closure date detailed on the Family Matters Institute website / recruitment website.
Please post a signed version to the address below (this version can be received after the closing date however will only be accepted if an electronic version has been submitted as above):
Family Matters Institute, Moggerhanger Park, Moggerhanger, Bedfordshire, MK44 3RW
For further information
Telephone: 01767 641002
FMI Websites:



Office Use Only
Meets Criteria Yes/No / Short listing Officer(s):
Invite to Interview Yes/No / Interview Panel:

Ref FMI Application Form Nov 2013

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