Kevin/C:\Users\Kevin\Documents\Shelter\RecruitmentProforma\ApplicationForm.doc

THE SHELTER TRUST

APPLICATION FOR EMPLOYMENT

The Shelter Trust supports equal opportunities in employment and access to services.

Return Address for application

The Shelter Trust

Soroptimist House
28 Pomona Road
St. Helier
Jersey
JE2 3XL / Contact Name
Kevin O’ Donnell
Ph. 01534 608948

Closing date for applications

PERSONAL INFORMATION

POST APPLIED FOR

Full Name

Address

Email

Contact Phone Number(s)
Date of Birth /

Age

/
Period of continuous residence in Jersey

PRESENT / MOST RECENT PAID EMPLOYMENT

Period /
Name and address of Employer
/ Details of Duties, Responsibilities, Salary and reason for wishing to leave
From / To
If you are offered this post, how much notice would you have to give?

PAID EMPLOYMENT HISTORY

Period / Name and address of previous employer / Details of Duties, Responsibilities, Salary and reasons for leaving
From / To

UNPAID WORK / VOLUNTARY WORK / WORK EXPERIENCE

Period / Name and address of employer/organisation / Details of Responsibilities, Duties, Nature of work
From / To
EDUCATION / QUALIFICATIONS / TRAINING
Period / Name & Nature of Establishment / Full/
Part
Time / Qualifications
(Give details, including dates of Qualifications or experience gained)
From / To

OTHER INFORMATION

Please state, why you feel that your experience and personality would suit you to this position.
Leisure / Other interests
Please list any other interests you feel may be relevant to this application

HEALTH

How many working days were you absent
due to illness in the last 12 months?
Please give details of any illness or disability which may affect your ability to fulfill this post(failure to disclose any known condition that later adversely affects your ability to fulfill the responsibilities of this post may be considered grounds for dismissal)

CHARACTER AND SUITABILITY

The Shelter Trust will seek to establish that an applicant for employment is of good character and is suited to the post applied for. The Trust will seek to establish this by requesting two (or more) written references and by asking the applicant to declare any relevant criminal convictions.

Do you have any pending prosecutions or unspent criminal convictions?

YES

/

NO

If you answer ‘yes’ you should set out details on a separate sheet. Any information given will be treated in the strictest confidence and will be viewed only by Senior Managers of the Trust. A criminal record will not necessarily exclude you from this post as the nature of the Offence(s) and the time lapsed since offending will be taken into account - we may wish to discuss this with you. The Trust may, with your written permission, seek confirmation of this information from appropriate persons.

Please list two reliable people who are able to give confidential information with regard to your previous experience and general good character. One or more of your referees should be able to cover your last three years of employment (if applicable) – details of further referees can be supplied on a separate sheet.

Name of employment Referee

/

Name of Referee

Occupation / Relationship to you

/

Occupation / Relationship to you

Address

/

Address

Phone

/

Phone

May we contact prior to interview? Yes / No

/

May we contact prior to interview? Yes / No

All information contained in this form will be treated in the strictest confidence. I declare that the information contained in this form is, to the best of my knowledge, correct.

Signed Date

Page 1 of 5Current @ Wednesday, 03 October 2018