Application Form

The information given on this form will be treated in confidence. Any offer of employment will be subject to a satisfactory enhanced disclosure and suitable references.

So that we compare candidates fairly, this form is the only document we consider when screening applications. Therefore, please do not send a CV, written references, examples of work or other examples of work unless specifically requested.

Personal Details

Position applied for

Title

First name

Last name

Date of birth

Month

Day

Year

Address

Postcode

National Insurance Number

Mobile

Education & Qualifications

Please give details of secondary and further Education including any A levels or equivalent vocational courses.

From

College/other

Qualification obtained and grade/level

From

College/other

Qualifications obtained and grade/level

Higher Education

From

Qualifications obtained and grade/level

Name of awarding body

From

Qualifications obtained and grade/level

Name of awarding body

Employment History

Please complete details of your present and previous employment as requested below.

Please include any part time or voluntary employment. Continue on a separate sheet if necessary.

Present Employment

Job Title

Employer

Current Salary

Address

Employed From

Employed To

Please give a brief description of current duties, responsibilities, and achievements

Previous Employment

Employed From

Employed To

Name of employer

Job title and main responsibilities

Reason for leaving

Employed From

Employed To

Job title and main responsibilities

Reason for leaving

Employed From

Employed To

Job title and main responsibilities

Reason for leaving

If there are any gaps in your employment or education history please explain them here

I.T Skills

Training will be provided where required.

Information given here will help us to plan training schemes.

Microsoft Word

Basic

Competent

High

Microsoft Excel

Basic

Competent

High

Microsoft Outlook

Basic

Competent

High

Basic

Competent

High

Referees

Please supply the names and contact details of at least two referees who can comment on your suitability for this position.

One should be your current or most recent employer.

(Note: if you are not currently working with children but have done so in the past the second referee should be the employer by whom you were most recently employed in work with children. References will not be accepted from relatives or persons who only know you as a friend).

Name

Position

In what capacity do you know the Referee?

Name of organisation

Address

Telephone Number

Name

Position

In what capacity do you know the referee?

Name of organisation

Address

Telephone Number

Please note that we will contact these referees if you are short-listed for this post and seek reference before interview.

Also, in relation to work with children, we will seek information about any past disciplinary issues relating to children and/or child protection concerns you may have been subject to.

If you have any concerns about this please contact Nikki on 07769515958 to discuss the issues.

Personal Statement

Please demonstrate using examples your suitability for the position you are applying for. Please include your reasons for applying and interest in this position.

For persons who are not British or EU nationals. If you have any conditions related to your employment, please give full details

Personal Declarations

The position for which you are applying involves contact with children and is exempt from the Rehabilitation of Offenders Act 1974 and all subsequent amendments (England and Wales).

For these positions you are not entitled to withhold information about police cautions, bind-overs, or any criminal convictions including any that would otherwise be considered ‘spent’ under the Act.

Have you ever been convicted of any offence or bound-over or given a caution?

Yes

If yes, please give details on a separate sheet and attach it to this form in a sealed envelope marked ‘Confidential – Disclosure’.

I understand that if my application is successful, I will be required to obtain an Enhanced disclosure at the appropriate level.

Yes

Declaration - PLEASE READ CAREFULLY

I declare that the information I have given on this form is complete and accurate

Yes

I confirm that I am not banned or disqualified from working with children nor subject to any sanctions or conditions on my employment imposed by the Independent Safeguarding Authority, the Secretary of State or a regularity body.

Yes

I understand that to knowingly give false information, or to omit any relevant information, could result in the withdrawal of any offer of appointment, or my dismissal at any time in the future and possible criminal prosecution.

Yes

Signature

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The information given on this form will be treated in confidence. Any offer of employment will be subject to a satisfactory enhanced disclosure and suitable references.

Position applied for

Date of birth

Month

Day

Year

National Insurance Number

Education & Qualifications

Please give details of secondary and further Education including any A levels or equivalent vocational courses.

Qualification obtained and grade/level

Qualifications obtained and grade/level

Name of awarding body

Qualifications obtained and grade/level

Name of awarding body

Please complete details of your present and previous employment as requested below.

Please include any part time or voluntary employment. Continue on a separate sheet if necessary.

Please give a brief description of current duties, responsibilities, and achievements

Job title and main responsibilities

If there are any gaps in your employment or education history please explain them here

Training will be provided where required.

Information given here will help us to plan training schemes.

Microsoft Word

Basic

Competent

High

Microsoft Excel

Basic

Competent

High

Microsoft Outlook

Basic

Competent

High

Basic

Competent

High

Please supply the names and contact details of at least two referees who can comment on your suitability for this position.

One should be your current or most recent employer.

In what capacity do you know the Referee?

Name of organisation

In what capacity do you know the referee?

Name of organisation

Please note that we will contact these referees if you are short-listed for this post and seek reference before interview.

Also, in relation to work with children, we will seek information about any past disciplinary issues relating to children and/or child protection concerns you may have been subject to.

If you have any concerns about this please contact Nikki on 07769515958 to discuss the issues.

Please demonstrate using examples your suitability for the position you are applying for. Please include your reasons for applying and interest in this position.

For persons who are not British or EU nationals. If you have any conditions related to your employment, please give full details

Personal Declarations

The position for which you are applying involves contact with children and is exempt from the Rehabilitation of Offenders Act 1974 and all subsequent amendments (England and Wales).

Have you ever been convicted of any offence or bound-over or given a caution?

Yes

If yes, please give details on a separate sheet and attach it to this form in a sealed envelope marked ‘Confidential – Disclosure’.

I understand that if my application is successful, I will be required to obtain an Enhanced disclosure at the appropriate level.

Yes

Declaration - PLEASE READ CAREFULLY

I declare that the information I have given on this form is complete and accurate

Yes

Signature

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