Application Form AUKCW

GDPR Notice
Your data will be processed in line with the Company’s Data Protection Policy in accordance with the General Data Protection Regulations. You can view our privacy policy on our website:

https://www.ageuk.org.uk/coventryandwarwickshire/privacy-policy/

(1) Employer Details
Please provide details of your employment history, starting with your most recent / current employer and working back. Please account for any gaps.
Job Title*
Name and Address of employer*

Name, Street Address

Street Address Line 2

CityCounty

Post Code
Phone Number*
Email contact for employer*
example@example.com
Start Date*

DayMonthYear
End Date

DayMonthYear
Reason for Leaving*
Brief summary of duties

0/80

Education
Provide details of your education history, starting with your most recent / current experience and working back. Please account for any gaps.
(1) Establishment
Start Date

DayMonthYear
End Date

DayMonthYear
Education Type
e.g. Degree
(2) Establishment
Start Date

DayMonthYear
End Date

DayMonthYear
Education Type
e.g. Degree
(3) Establishment
Start Date

DayMonthYear
End Date

DayMonthYear
Education Type
e.g. Degree

Provide details of your qualifications which are relevant to the job.

References
Please give the details of two professional referees, one of which must be your current or most recent employer. Under GDPR you must ensure that the referees have given consent for us to contact them for the purposes of obtaining a reference.
Name of Reference 1*

First NameLast Name
Your relationship to reference 1*
Phone Number- reference1*
Years Known- reference 1*
Email of Reference*
example@example.com
Address- reference 1

Street Address

Street Address Line 2

CityCounty

Post Code
Can we seek this reference 1 without further consent from you?*

YesNo
Name of reference 2*

First NameLast Name
Your relationship to reference 2*
Phone Number- reference 2 *
Years Known- reference 2 *
Email of Reference*
example@example.com
Address- reference 2

Street Address

Street Address Line 2

CityCounty

Post Code
Can we seek this reference 2 without further consent from you?*

YesNo

How Do You Match the Requirements of the Person Specification?
In this section you must ensure you demonstrate fully how you meet each of the criteria set out in the person specification of the post you are applying for including any experience, skills and abilities that you have gained, both in work and outside paid work such as voluntary/community work. You may find it helpful to address each of the criteria in turn. You can submit underneath, or upload a separate file*

0/400
You can upload a separate document if you wish here:

Cancelof
Additional Questions
Do you have any unspent criminal convictions, bind-overs or cautions? PLEASE NOTE that spent convictions, bind-overs and cautions must not be disclosed*

YesNo
Are there any criminal proceedings pending against you?*

YesNo
If YES, please supply the following details: nature of offence(s), date of conviction(s), penalty. NOTE these details will be held on a strictly confidential basis, separate from the rest of your application. They will be held in compliance with the GDPR and related UK data protection legislation and only discussed with the selection panel where it is relevant to the post for which you have applied
Are you related to, or have a personal relationship with a Trustee or Employee of Age UK Coventry & Warwickshire? (Failure to make proper disclosure shall disqualify you for the appointment, and if appointed, shall render you liable to dismissal without notice.) Please provide details*

Declaration, Signature and Date
Declaration and Signature: With this application, I hereby consent to the information in this form being retained for recruitment, selection and employment related purposes. I understand that any offer of employment is subject to the relevant pre-employment checks including but not limited to satisfactory a) Verification of identity b) References, c) DBS Certificate and check of the barred list/s (if applicable), d) Proof of eligibility to work in the UK e) Proof of qualifications and registrations. I declare that all statements I make in this application are true and, to the best of my knowledge and belief, that I have not withheld any relevant information. I understand that if I have made any false statements or omitted any information, I am liable to have my application rejected, or if appointed, liable to be dismissed. *

Clear
Date*

DayMonthYear
Should be Empty:

Job Application Form