Sandwell Council of Voluntary Organisations

APPLICATION FORM

PLEASE TYPE OR WRITE CLEARLY IN BLACK INK

POSITION APPLIED FOR

POSITION:Fundraiser

PERSONAL DETAILS

TITLE(‘other’ please state)

SURNAME/FAMILY NAME

FIRST/OTHER NAME

ADDRESS

POSTAL CODE

TELEPHONE (DAYTIME)

TELEPHONE (EVENING)

EMAIL ADDRESS

DO YOU REQUIRE A WORK PERMITYESNO

REFERENCES

Please produce the names, addresses and occupations of two persons from whom we can obtain references. One of these must be your current or most recent employer.

NAME:

OCCUPATION:

ADDRESS:

TELEPHONE:

RELATIONSHIP TO YOU:

NAME:

OCCUPATION:

ADDRESS:

TELEPHONE:

RELATIONSHIP TO YOU:

I certify that to the best of my knowledge and belief all information included or attached to this application is true and correct. I understand that the provision of false or fraudulent information will invalidate this application and, if appointed, will be grounds for summary dismissal.

SignatureDate

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SECTION A

BACKGROUND/EXPERIENCE.

Please refer to the enclosed information for applicants before completing these sections.

PRESENT/MOST RECENT EMPLOYMENT

Name of Employer

Employer’s Address

Telephone

Position Held/Job Title

Date Appointed

Current Salary/Wages£per

Grade/Scale (if applicable)

Other Benefits, if any

(e.g. Pension, Medical, etc)

Leaving Date/Notice Period

Reasons for Leaving

Please give a brief description of your main duties and responsibilities in your current or most recent position.

PAID AND/OR UNPAID WORK EXPERIENCE

Briefly outline your previous paid employment/voluntary work/community activities and any other activities – starting with the current/most recent

From: / To: / Name/address of Employer/Organisation / Position/Role, Duties & Reason For Leaving (if applicable) / Salary/Wage (if applicable)

SICKNESS ABSENCE

Please give the number of different instances of sickness absence and total number of days sick you have taken in the last twelve months.

Number of AbsencesNumber of days taken

If you wish, please give brief details …

EDUCATIONAL QUALIFICATIONS

Briefly outline any education qualifications you hold, commencing with the highest level qualification.

Dates / University/College/School / Qualification / Grade

OTHER TRAINING/COURSES

Briefly outline any other training or courses you have undertaken which you feel may be relevant to your application.

Dates / Course / Course Provider / Qualification (if applicable)

MEMBERSHIP OF PROFESSIONAL BODIES/ASSOCIATIONS

Please list any professional bodies/associations of which you are currently a member.

Professional Body / Membership Level / Dates

CRIMINAL OFFENCES/CONVICTIONS

Please give details of any unspent criminal convictions and/or any proceedings pending against you. Certain positions, due to the nature of the work involved, may be offered subject to the provision of a disclosure and barring service check.

SECTION B

ADDITIONAL INFORMATION

Using the space below and any continuation sheets as required, please give any additional information you think will support or help us in considering your application in view of the quality required in the person specification. You may wish to include further details relating to your present position or duties, other relevant experience or specialist knowledge you have, etc.

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EQUAL OPPORTUNITIES MONITORING

SCVOstrives to be an equalopportunities employer

ETHNICITY

AWHITE

British

Irish