FOR OFFICE USE

Short list :

Ref req. :

Ref rec. :

Interview :

Application

Please be aware that there are certain legal restrictions which apply to taking up employment in the UK. When completing this form you will be asked whether you have the right to take up employment in the UK.

Please return to: / Please return applications to Deborah Griffiths at or post to The College Business Centre, Uttoxeter New Road, Derby.
at CSV by: / 6 March 12pm
Application for the post of: / SAV1417 Project Assistant

We would be grateful if you could type or write in black (if completing by hand), confining your answers to the space provided. Please do not send CVs as they will not be considered.

Full name
Home address
Home telDaytime tel Mobile tel
Email:

Present or most recent employment/voluntary work

Post held Date started If left, date left
Name of employer Salary
Reasons for Leaving
Address of employer

Details of your previous appointments (except for the most recent)

Employer Post held Dates / Post held / Dates

What formal education, vocational/professional qualifications and training do you have?

You only need to be specific about those which are relevant to the post.

Venue Date Examinations/Qualifications/Training Courses

If appointed, when could you begin?

Referees (we need references from two of your most recent employers, one of whom must be your present employer if possible. If you are unable to do this please provide the names of academic or professional referees )

Name Name / Name
Address / Address
Organisation: / Organisation:
Position in Organisation
Kfdskfalfkldfk
Dlsdkfsalfkl;kl / Position in Organisation:
Their Relationship to you: / Relationship to you:
Contact tel / Contact tel
Fax : / Fax :
Email : / Email:

Please put a cross in the box if you do not wish us to contactany of your refereesbefore interview. We need to receive at least one reference prior to interview.

Why do you want this job?

Please tell us about your past/present volunteering or community activities. If there are any additional activities you think we should know about please enter details here.

In deciding who to shortlist and appoint to this post, we will be looking for evidence that you meet the person specification. Please indicate clearly, using examples, the ways in which you meet the requirements of the person specification. You may draw on skills, abilities and experience gained through work, whether paid or voluntary, spare time interests, and activities such as child rearing or home keeping.

Any other information relevant to your application - in particular if the job description specifies requirements or skills (e.g. driving licence) which you have not already mentioned.

Do you have any disability or impairment which you would like us to take into account? Any applicant who advises us of a disability or impairment and who meets the essential criteria in the person specification will be guaranteed an interview.

Do you have a relative or partner who works at CSV? Please give their name and relationship to you.

Do you have theappropriate leave to work in the UK for the job you have applied for? Yes/ No

The British Asylum and Immigration Act requires that all successful candidates must provide evidence of their immigration status and eligibility to work in the UK. You will be asked to provide evidence, if you are called for an interview.

If you are sending your application form by e-mail, please place an X next to the sentence below to indicate that the information provided on this form is true.

Signature of applicant<click here and place an X if sending by e-mail>

Date:

Equal opportunities policy

CSV is committed to Equal Opportunities. To help us achieve our aim we need to collect and analyse information about people applying for jobs with us. There is an Equal Opportunities questionnaire enclosed with this form we ask you to complete it and return it with your application. If you do not wish to give this information, please tick ‘information with held’ at the top of the form.

Please note:

As a charity, our resources are limited so returned application forms will be acknowledged only if a stamped self-addressed envelope is enclosed. If you do not hear from CSV by the advertised interview date, you may assume that your application has been unsuccessful. CSV are not able to provide feedback to unsuccessful applications who are not shortlisted.

Interviewers notes:

Head Office: 237 Pentonville Road, LondonN1 9NJ

CSV creates opportunities for people to play an active part in the life of their community.

CSV is a company limited by guarantee registered in England no. 1435877, and is a registered charity in England no. 291222 and in Scotland no. SCO39171.