job application form

Heathcot Pre-School Ltd

Job application form
Application for the post of:
Personal details
Name

First NameSurname
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home No:
Please enter a valid phone number.
Mobile no:
Please enter a valid phone number.
Work no:
Please enter a valid phone number.
Can we ring you at work?

YesNo
Email address:
example@example.com
References

Please give the names and full addresses of two people who can verify or confirm your employment record. One must be your line manager at your current/last employer. Please do not use relatives, partners or friends as referees.
Name:
Position held and relationship:
Organisation name and address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone no:
Please enter a valid phone number.
Email Address:
example@example.com
May we contact the referee before interview?

YesNo
Name:
Position held and relationship:
Organisation name and address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone no:
Please enter a valid phone number.
Email address:
example@example.com
May we contact the referee before interview?

YesNo
Recruitment monitoring form – confidential

We are committed to equal opportunities in employment. As part of this policy, all applicants for employment are requested to complete this section for the purposes of monitoring the policy and it will be separated from your application. The information it contains will not be used in deciding whether or not to invite you to interview or offer you employment. As an equal opportunities employer, we aim to ensure that no job applicant or employee receives less favourable treatment on the grounds of age, sex, race, colour, marital status, religion, ethnic origin, nationality or sexual orientation. Please help us achieve our main aim by completing the following questions:
Position applied for:
Name (forename(s) and surname in full):

ForenameSurname
Date of birth:

MonthDayYear
Date
Age:
If you are invited to attend an interview or take up employment and require special arrangements please give details below:
Do you consider yourself to have a disability?

YesNo
Gender

MaleFemale
I would describe my race or ethnic origin as (please tick appropriate box):
White

White BritishWhite IrishWhite other
Black

Black BritishBlack AfricanBlack CaribbeanBlack other
Asian

BangladeshiPakistaniIndianAsian other
Chinese

ChineseChinese other
Mixed

White and Black CaribbeanWhite and Black AfricanWhite and Black Asian
Other please state:
Only complete this section if the job description indicates that the post is exempt from the provisions of the Rehabilitation Act 1974.
Have you ever been convicted, cautioned or reprimanded for a criminal offence?

YesNo
Are you on either of the 2 lists banning you from working with children or vulnerable adults imposed by the Independent Safeguarding Authority?

YesNo
If yes, please give details and dates in the space provided below:
Do you need a work permit to work in the UK?

YesNo
National Insurance Number:
How did you find out about this vacancy? (Please give the name of the newspaper/journal/website.)
I consent to Heathcot pre-school to hold the data in the equal opportunities section of this form in their database and manual file.
Signature of applicant:

Clear
Date

MonthDayYear
Date
(INTERNAL USE ONLY) Applicant Reference Number:

Qualifications achieved (start with the most recent):

	Secondary Schools, Colleges, Universities	From	To	Brief details of course and qualifications taken	Grade

Study currently being undertaken:

	Secondary Schools, Colleges, Universities	From	To	Brief details of course and qualifications taken	Grade

Professional or other qualifications, apprenticeships,memberships of professional organisations:
Other training you have received which you consider relevant:
Employment history
Current/most recent employment:
Name and address of employer:
Date Started:

MonthDayYear
Date
Until:

MonthDayYear
Date
Notice required:
Job title:
Basic salary per annum:
Brief description of duties:
Reason for leaving:
Other employment/career history starting with the most recent:

For posts which involve working with children, please give your full employment history; accounting for any gaps (please continue on a separate sheet of paper if necessary).

	Post	From	To	Employer/organisation name and address	Reason for leaving

Please give details of other interests, including involvement in voluntary organisations, which you consider relevant:
Experience/relevant skills

Having read the job description and person specification, please state how your experience and achievements to date would make you a suitable candidate for this post. You should address each criteria detailed on the person specification and provide examples of how you meet these.
If you need to continue beyond this page of the form, please use A4 sized white paper.
Do you have a driving licence?

YesNo
Do you have access to a vehicle?

YesNo
Do you have access to public transport?

YesNo
Do you have any relationship (i.e. family, friends) with anyone working for the pre-school?

YesNo
Declaration

Any of the above particulars may be subject to check. I understand that any false, inaccurate or incomplete information could result in dismissal, disciplinary action or withdrawal of any offer of employment.

I declare that the information given on this is, to the best of my knowledge, correct and complete and can be treated as part of any subsequent contract of employment.

I understand that the pre-school may process, by means of a computer database or otherwise, any information which I provide to it, for the purpose of employment with the pre-school.
Signature of applicant:

Clear
Date

MonthDayYear
Date
Please return this application form in an A4 sized envelope marked ‘PRIVATE & CONFIDENTIAL’ to:

HEATHCOT PRE – SCHOOL LTD
78 WINDSOR ROAD
COPPICE
OLDHAM
OL8 1RP
Should be Empty:

Heathcot Pre-School Ltd

Employment history

Other employment/career history starting with the most recent: