Application Form

DETAILS OF POSITION APPLIED FOR

Position Applied For (required)

Other, please state

Location (required)

Days & Times Available (required)

PERSONAL DETAILS

First Name (required)

Second Name (required)

Title

Address 1

Address Line 2

Town/City (required)

County (required)

Post Code (required)

NI Number

Email Address

Telephone No.

I confirm I have the right to work in the UK

YesNo

Do you have UK employment restrictions (required)

YesNo

If yes, please provide details

EDUCATION HISTORY

List qualifications, including dates obtained (required)

Other training, including dates obtained

Other Employment (please provide details of other employment or volunteering roles you would continue with if you were successful in obtaining the position applied for)

EMPLOYMENT HISTORY

Please provide details of previous employment in full with present/last job first

MOST RECENT POSITION

Dates of Employment

Name & Contact Details of Employer

Job Title

Responsibilities

Reason for leaving

POSITION TWO

Dates of Employment

Name & Contact Details of Employer

Job Title

Responsibilities

Reason for leaving

POSITION THREE

Dates of Employment

Name & Contact Details of Employer

Job Title

Responsibilities

Reason for Leaving

POSITION FOUR

Dates of Employment

Name & Contact Details of Employer

Job Title

Responsibilities

Reason for Leaving

Please list any other employment details here

Other Employment Details

REFERENCES

Provide two names and their contact details from whom we may obtain both character and/or work experience references

Reference 1 (required)

Reference 2 (required)

LEISURE

Provide details of your leisure interests, sports and hobbies, or any other pastimes etc (required)

CRIMINAL RECORD

Note any criminal convictions except those ’spent’ under the Rehabilitation of Offenders Act 1974. If none, please state. In certain circumstances employment/ voluntary position is dependent upon obtaining a satisfactory basic disclosure from the Criminal (required)

GENERAL COMMENTS

Detail here your reasons for this application, your main achievements to date and the strengths you would bring to this post. Specifically, please detail how your knowledge, skills and experiences meet the requirements of this role (as summarised in the p (required)

DECLARATION

DECLARATION (required)

I confirm that the information I have provided is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract /volunteer position offered.I agree that the organisation reserves the right to require me to undergo a medical examination. (Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor). I agree that this information will be retained in my personnel file during employment/voluntary position and for up to six years thereafter and understand that information will be processed in accordance with the Data Protection ActI agree that my previous employers may be approached for references, if required, in addition to those reference details supplied. I also agree that should I be successful in this application, I will, if required, apply to the Criminal Records Bureau/Scottish Criminal Records Office for a standard or enhanced (as appropriate) disclosure. I understand that should I fail to do so, or should the disclosure or reference not be satisfactory, any offer of employment/ volunteer position may be withdrawn or my employment/ volunteer position terminated.

Date of submission (required)

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