Job Application Form

Education and Training
Secondary School attended
From

DayMonthYear
Date
To

DayMonthYear
Date
Qualifications gained including subjects and grades
College/University attended
From

DayMonthYear
Date
To

DayMonthYear
Date
Qualifications gained including subjects and grades
College/University attended
From

DayMonthYear
Date
To

DayMonthYear
Date
Qualifications gained including subjects and grades
Other training courses (with dates)
Membership of professional and technical bodies (if appropriate)
Details of other qualification being sought
To provide more information about education and training please add on a separate sheet and upload

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Employment Details
Please start with your most recent post and work backwards.
Post held
From

DayMonthYear
Date
To

DayMonthYear
Date
Grade and salary
Employer name and address
Reasons for leaving
Post held
From

DayMonthYear
Date
To

DayMonthYear
Date
Grade and salary
Employer name and address
Reasons for leaving
Post held
From

DayMonthYear
Date
To

DayMonthYear
Date
Grade and salary
Employer name and address
Reasons for leaving
Post held
From

DayMonthYear
Date
To

DayMonthYear
Date
Grade and salary
Employer name and address
Reasons for leaving
To provide more information about employment please add on a separate sheet and upload

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Referees
Please give the names and addresses of TWO referees. One should be your present/most recent employer.
Referee One Name
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Email
example@example.com
Phone Number

Area CodePhone Number
Occupation
Number of years known
Referee Two Name
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Email
example@example.com
Phone Number

Area CodePhone Number
Occupation
Number of years known

Other Information
Health

Please give details of any absences from work on health grounds over the last three years.
Health
Rehabilitation of Offenders Act 1974

As you may be in contact with children and vulnerable people, a Disclosure and Barring Service Check is required.

You must declare all criminal convictions as the Rehabilitation of Offenders Act does not apply to this post.
Please give details
Are you related to any members of the Feelgood Factory Board of Trustees or employees?

YesNo
If "yes", please give details.

Declaration and Submission
I declare that the information given on this form is to the best of my knowledge correct. I understand that canvassing, either directly or indirectly, of any Trustees or employees of the Netherton Feelgood Factory, or the giving of false or misleading information, may lead to disqualification or, if appointed, may result in dismissal.
Signed*
Date*

DayMonthYear
Date
Please state where you saw the vacancy
Data Protection

Any information and data given will be treated as confidential, stored securely and used only in connection with the recruitment process for the post named at the beginning of the form. By giving information you agree to the Netherton Feelgood Factory contacting you by email, telephone or post in connection with the application. Information given by successful applicants will be used to form a personnel file. Information given by unsuccessful applicants will be destroyed within four weeks of the final interviews.
Should be Empty:

Employment Application Form