Application Form

Application Form

Application Form
Safe and fair recruitment commitment:

Our organisation is committed to safeguarding and promoting the welfare of adults at risk and/or children and expects all our staff and volunteers to share these values. We are also committed to treating all applicants equally and fairly based on their skills, experience, and ability to fulfil the duties required of the role applied for. This is regardless of any protected characteristics (ethnicity, gender or gender re-assignment, religion or belief, sexual orientation, physical/mental disability, age, pregnancy or maternity, marriage, or civil partnership Applicants must share with us all the relevant information that we have requested in this application form, but we would like to reassure applicants that any information provided will be treated in the strictest confidence in a fair and open manner. Suitable applicants will not be refused employment because of offences or conduct which are no longer relevant, and do not place them at, or make them a risk in - the role for which they are applying. We will ensure that all our recruitment and selection practices reflect this commitment.
Post details
Post applied for*
Where did you see the post advertised
Closing date*

MonthDayYear
Date

Personal details
Name*

Full nameLast name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone number*
Format: 000 000 00000.
Email*
example@example.com
Preferred contact method*

Education and training

Details and results of any exams taken
Name of School/ College/ University
Dates:
Qualification
Grade (if applicable)
Name of School/ College/ University
Dates:
Qualification
Grade (if applicable)
Further Education/Training (please mention dates, name of institution, qualification, grade where applicable):

Professional registration
Please include: Professional body, Registration/membership level, Date awarded*

Current employment
YesNo
Name and address of employer
Current job title
Start date

MonthDayYear
Date
Contract type permanent temporary etc
Salary (including allowances)
Notice period
Reason for leaving
Key duties
No approach will be made to your present employer before an offer of employment is made to you.

Employment history

Please provide full employment history in chronological order since leaving secondary education, including periods of any post-secondary education/training, and part-time and voluntary work as well as full time employment, with start and end dates. IMPORTANT NOTE: When providing reason for leaving, for each role, please confirm that you were not under investigation for or subject to any disciplinary sanctions in relation to your conduct at the time of leaving/dismissal. If you were, please provide details
Please let us know about any gaps in employment, education or training history. Please detail each period (of more than four weeks).
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving
Employer name
Employer address
Your job title
Main duties
Start date

MonthDayYear
Date
End date

MonthDayYear
Date
Reason for leaving

Supporting Statement
Please give details of your skills, abilities, experience and personal qualities to demonstrate how you meet the criteria in the person specification, using examples wherever possible.*

Referees

Please provide contact details for at least two referees who are able to comment on your suitability for the job applied for. You are responsible for providing accurate contact details so that referees can be contacted. The first referee MUST be your current or most recent employer (or your course tutor if you are currently in, or have just left, full time education). Professional references will not be accepted from work colleagues who are not authorised to provide professional references in an official capacity on behalf of the organisation, or from people writing solely in the capacity of friends, or from relatives.
Referee 1 (Current/ Most Recent Employer)

Or your Course tutor if you are currently in or just have left full time education)
Name*

First NameLast Name
Organisation*
Position*
Address*
Phone Number*
Please enter a valid phone number.Format: 000 000 00000.
Email*
example@example.com
Referee 2
Name*

First NameLast Name
Position/Relationship to the candidate*
Address*
Phone Number*
Please enter a valid phone number.Format: 000 000 00000.
Email*
example@example.com
Our organisation will seek references on successful candidates, and will approach previous employers for information to verify particular experience or qualifications. If you are currently working with adults at risk and/children, your current employer will be asked about disciplinary offences relating to adults at risk and/children (including any conduct related to safeguarding concerns which the penalty is ‘time expired’), and whether you have been the subject of any safeguarding related investigations or concerns, and if so, the outcome of any enquiry or disciplinary procedure including any referrals to Disclosure and Barring Service (DBS), other professional bodies or the police. If you are successful at interview, any offer of employment will be subject to receipt of two satisfactory references and any additional pre-employment checks.

I declare that the information I have given in this application is correct and complete. I understand that any false statements or failure to disclose information requested on this form may result in my application being disqualified or may lead to my dismissal or disciplinary action if appointed.
I understand that if I am appointed, personal information about me may be stored for personnel/employee administrative purposes in accordance with relevant Data Protection legislation, including UKGDPR/DPA 2018 and any other UK legislation which supports it.
Our organisation will process the data you give us to determine your suitability for the role you have applied for as part of the recruitment process and the ongoing employment relationship if appointed.
In submitting this form, I give my authority for use of my personal data for thepurposes outlined above.
Signature*

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Date*

MonthDayYear
Date
All information on this form will be treated in strictest confidence and used to process your application for employment. If you are appointed, this application will form the basis of your personal file and information on this may be held in an electronic database. If your application is unsuccessful your details will be kept for a period of 6 months and then destroyed.
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