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Recruitment

This is a confidential application for employment. Please complete as many fields as possible, if you are unable to answer a question then please leave it blank.

What position are you applying for?

Personal Details

Preferred Title for Correspondence

Forenames

Surname (Family Name)

Home Tel. Number

Work Tel. Number

May we contact you at work? Yes
No

Home Address







Are you legally eligible for employment in this country? Yes
No

If no, do you have current work permit? Yes
No

Do you hold a current full driving license? Yes
No

If yes, please give details of current endorsements, if any?

Do you have use of a vehicle for work? Yes
No

Professional Registration Number (if applicable)



Pin No. (if applicable)



Where did you see this post advertised?

Employment

Present appointment or most recent.
Name of Employer

Address







Tel. Number

Post Held



Period of Notice

Please give a description of your duties:
Reason for Leaving

Basic Salary

Previous Employment

Previous appointments, listing your most recent first.
1) Name of Employer

1) Address







1) Post Held



1) Reason for Leaving



2) Name of Employer

2) Address







2) Post Held



2) Reason for Leaving



3) Name of Employer

3) Address







3) Post Held



3) Reason for Leaving



4) Name of Employer

4) Address







4) Post Held



4) Reason for Leaving

Educational Qualifications

Subject 1







Subject 2







Subject 3







Subject 3







Subject 5







Subject 6







Subject 7







Subject 8







Subject 9







Subject 10

Professional Qualifications

Qualification 1





Qualification 2





Qualification 3





Qualification 4

Other Qualifications & Training Courses

Please give details of any other qualifications or training courses you have attended which are relevant to the post applied for.

Proposed Further Education

Please give details of any training you are currently considering.

Additional Information

Please give your reasons for making this application. Please add any further information that may support your application, e.g. relevant past experience, skills learned in work or in home management, leisure activities and special interests. Please draw our attention in particular to your main achievements and how these will help you to succeed in this post.

Rehabilitation of Offenders

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Applicants are, therefore, not entitled to withhold information about convictions which for other purposes are 'spent' under the provisions of the Act, and, in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the company. You must, therefore, provide details of ALL previous convictions, cautions and bind-over orders, conditional discharges or breach of byelaws, as well as any details of any pending prosecutions. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975 applies.

Do you have a prosecution pending or have you been convicted at a court or cautioned by the police for any offence? Yes
No

If yes, please give details:

Disability Discrimination

The organization is committed to interviewing all applicants with a disability, who meet the minimum criteria for a job vacancy, and consider them on their abilities.

The Disability Discrimination Act 1995 defines a person as having a disability s/he has "a physical or mental impairment, which has substantial and long term adverse effect on his/her ability to carry out normal day to day activities".

Do you have any condition that has or could have a disabling effect on this post? Yes
No

Do you require any special arrangements if selected for interview? Yes
No

If yes, please specify:

References

Please give names and addresses of two referees, including telephone numbers, if possible, who can be expected to provide relevant comment on your ability to carry out the job applied for. At least one should be your present (last employer if not employed, or school/college student).

References will normally be taken up for shortlisted candidates only, prior to interview.

1) Referee Name

1) Address







1) Tel. Number

1) How are you known to the referee?



2) Referee Name

2) Address







2) Tel. Number

2) How are you known to the referee?

If you do not wish any reference to be sought until you give permission, please check the relevant box. Referee 1
Referee 2

I certify that, to the best of my knowledge, the information I have given above is true and complete. I understand that any false information given on this form may render an offer of employment invalid and lead to termination of employment. I also understand that the appointment is subject to Enhanced Criminal Records Bureau clearance and receipt of two satisfactory references. Information provided as part of your application may be used for monitoring purposes, which assist the organization in complying with Equal Opportunities legislation and compiling statutory returns.