Job Application Form

Job Application Form
Thank you for applying for a position with Newport Live.

The information requested in this form is important in assessing your application. Please complete it accurately and in full. A CV on its own will not be accepted. We do not automatically acknowledge receipt of application forms or write to applicants not selected for interview. If you do not hear anything within 6 weeks of the closing date, please assume that your application has been unsuccessful.

Please fill in all sections of the form provided. If you have any questions in relation to this application form please contact 01633 656757.

If you require a hard copy of the application form, or if you are struggling to complete the application online, please email jobs@newportlive.co.uk Thank you.

Post Details
Job Title of post applied for*
Personal Details

(Information provided subject to the Data Protection Act 2018)
Title*
Mr, Mrs, Miss, Ms, Other
Name*

FirstLast
Contact number*
Please enter a valid phone number.
Email*
example@example.com
NI Number
(Available from the Department of Work and Pensions)

Qualifications achieved from secondary, higher and further education

(Please start with the most recent and list in chronological order)

	Type GCSE, NVQ, Degree etc.	Subject	Grade	Date achieved (dd/mm/yy)
1
2
3
4
5
6
7
8
9
10
11
12

Other training, courses and personal development

(Please start with the most recent and list in chronological order)
I have completed a number of training, courses and personal development

Training, courses and personal development [ 1 ]
Name of provider/college
Title of course/training, e.g. First Aid at Work
Qualification/ Level (if relevant)
Date

DayMonthYear

Training, courses and personal development [ 2 ]
Name of provider/college
Title of course/training, e.g. First Aid at Work
Qualification/ Level (if relevant)
Date

DayMonthYear

Training, courses and personal development [ 3 ]
Name of provider/college
Title of course/training, e.g. First Aid at Work
Qualification/ Level (if relevant)
Date

DayMonthYear

Training, courses and personal development [ 4 ]
Name of provider/college
Title of course/training, e.g. First Aid at Work
Qualification/ Level (if relevant)
Date

DayMonthYear

Training, courses and personal development [ 5 ]
Name of provider/college
Title of course/training, e.g. First Aid at Work
Qualification/ Level (if relevant)
Date

DayMonthYear

Current or most recent employment

Note: If you are applying for your first job, please provide any voluntary work/work experience in the “Previous employment or experience” section.
Employer name:
Job Title:
Employer Address:

Street Address

Street Address Line 2

CityRegion

Postcode
Main duties and responsibilities:
Reason for leaving:
Start Date:

DayMonthYear
Leave Date

DayMonthYear
(if applicable)
Period of Notice:

Previous employment or experience

Start with the most recent and list in chronological order working backwards. Please explain any gaps in your work history since you left education (e.g. unemployment; career breaks; family; voluntary work; travel etc).
I have had the following previous jobs…

Job 1
Employer
Date from

DayMonthYear
Date to

DayMonthYear
Job title, duties and responsibilities
(Include any reason for gaps)
Reason for leaving

Job 2
Employer
Date from

DayMonthYear
Date to

DayMonthYear
Job title, duties and responsibilities
(Include any reason for gaps)
Reason for leaving

Job 3
Employer
Date from

DayMonthYear
Date to

DayMonthYear
Job title, duties and responsibilities
(Include any reason for gaps)
Reason for leaving

Job 4
Employer
Date from

DayMonthYear
Date to

DayMonthYear
Job title, duties and responsibilities
(Include any reason for gaps)
Reason for leaving

Job 5
Employer
Date from

DayMonthYear
Date to

DayMonthYear
Job title, duties and responsibilities
(Include any reason for gaps)
Reason for leaving

Membership of Professional Bodies

	Body	Grade of Membership	Whether by exam	Date (dd/mm/yy)
1
2
3
4
5
6
7
8
9
10
11
12

Additional information

The information you provide in this section is important in assessing your application. Please use the space to state your reasons for applying for the post and relate your answers to the Person Specification including experience, qualifications, skills and personal qualities. (Please use a separate sheet if required and keep the Additional Information to a maximum of 1500 words)
Additional information*

Selection requirements

We will make reasonable adjustments to help people with disabilities or specific needs through the application and selection process. If you have any specific requirements to enable your participation and/or attendance during the selection process, please let us know:

Declaration of criminal convictions
If this post is exempt from the Rehabilitation of Offenders Act 1974, you will be required to disclose all criminal convictions, including any which may be ‘spent’. You should also include details of any cautions, reprimands or final warnings. Please only include details of old and minor cautions, convictions, reprimands and warnings in accordance with the DBS filtering rules relating to such offences. Details of the filtering rules can be found at www.gov.uk/dbs
Have you ever been convicted of any criminal offence, whether ‘spent’ or ‘unspent’, as defined in the Rehabilitation of Offenders Act 1974 or do you have any charges pending?*

YesNo
Please provide details*
Have you ever been cautioned, reprimanded or received a final warning which although not considered to be criminal convictions and become ‘spent’ immediately, must be considered in relation to this exempt post?*

YesNo
Please provide details*
Have you ever been barred or restricted from working with children or vulnerable Adults?*

YesNo
Please provide details*
Any subsequent offer of employment will be subject to a DBS check (enhanced disclosure ) from the Disclosure and Barring Service (DBS) where applicable. This check will include details of cautions, reprimands or final warnings as well as convictions. Appointment will be subject to the information received from the DBS.

I accept that if any of the information is found to be false or misleading I will be disqualified from appointment. I understand that any subsequent offer of employment will be subject to the outcome of a DBS check from the DBS and that Newport Live will request my authorisation for such a check to be made (where applicable).
Signature*

Clear
Date*

DayMonthYear

References

Please provide 2 references. Do not use friends or relatives.

Reference 1
Name*

First NameLast Name
Job Title*
Employer*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Relationship to you*

Reference 2
Name*

First NameLast Name
Job Title*
Employer*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Relationship to you*
Can we contact your references before a provisional job offer has been made?*

YesNo
Tick if you do not wish for the references to be contacted until a provisional offer of employment is made.

How we protect your personal information
We keep on file information from the job application form, equal opportunities form and any documents you attach. This is required for recruitment and equal opportunities monitoring purposes, the payment of staff and the prevention and detection of fraud. All information will be dealt with in accordance with data protection legislation and will not be sold to any third party. Unsuccessful application forms will be destroyed after 12 months; anonymised data will be kept for monitoring purposes.

Your declaration

I understand that any employment, if offered, will be subject to the information on this form being correct and I confirm that no valid information has been wilfully withheld. I understand that if I am appointed, I am liable to dismissal without notice if the information on this form is later proved to be inaccurate.
Signature*

Clear
Date*

DayMonthYear
Please sign and date before any offer of employment is made.
If you have completed this form on behalf of the applicant, please add your details:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.

Thank you for taking the time and effort to complete this application form.
Should be Empty:

Job Application Form

Post Details

Personal Details

Qualifications achieved from secondary, higher and further education

Other training, courses and personal development

Current or most recent employment

Previous employment or experience

Membership of Professional Bodies

Additional information

Selection requirements

Declaration of criminal convictions

Disclosure of interest

References

How we protect your personal information

Your declaration

Equal opportunities monitoring form

Thank you for taking the time and effort to complete this application form.