DOMESTIC VIOLENCE INTERVENTION PROJECT

APPLICATION FORM

Male Independent Domestic Violence Advocate PT

Please return completed form to:

Personal Details

Name:

Address:

Email:

Phone:

Can we contact you during office hours?:

Educational details
Please give details of your academic, professional and other qualifications relevant to this post:
Place of study / Subject / Qualification / Dates & duration

Previous work experience

Please give details of all previous relevant work:

Job title / Name and address of employer / Duties and responsibilities / Dates and duration / Reason for leaving and salary

Please list relevant courses and training for this field of work which have not led to formal qualifications:

Place of study / Subject / Dates and duration

Please give details including dates and durations of any absences from work during the last 2 years.

Person Specification

Please indicate, with specific examples, how you fulfil each of the items of the person specification for this post (attach extra sheets if required):

Previous Convictions

All applicants are required to disclose any previous convictions and/or pending court appearances. Previous convictions will not constitute an automatic bar to consideration of your application. However, in the event of an applicant being offered a post with DVIP, failure to disclose previous convictions or pending court appearances could result in immediate dismissal. Please note that it is DVIP’s policy to obtain enhanced disclosures from the CRB for all employees due to the highly sensitive nature of our work.

Have you ever been charged with and/or convicted of any violence related offence in this country or elsewhere (if yes, please give details of charges, circumstances and outcomes)?

Other previous convictions (charges and dates)

Are there any criminal charges currently being brought against you (if yes, please give details)?

Declaration

I wish to be considered for the post of Male Independent Domestic Violence Advocate PT for DVIP. I hereby declare that all the information contained within this application form is accurate to the best of my knowledge.

Signed: date:

Printed name in full:

References
We require that you provide contact details for three persons to whom DVIP can apply for information as to your suitability for this post. Referees must include your current / previous employer and need to cover at least the last 3 years. Posts are offered subject to references, we will request references prior to making an offer of employment.
Name:
Relationship to applicant (nature and length):
Email:
Phone: / Name:
Relationship to applicant (nature and length):
Email:
Phone:
Name:
Relationship to applicant (nature and length) :
Email:
Phone:

Domestic Violence Intervention Project

Equal opportunities monitoring form

DVIP is committed to equal opportunities. We are asking all candidates to complete this form. The information in the form will be used solely to review our advertising and recruitment process to ensure it operates in line with our equal opportunities policy. Your answers will be treated confidentially and we will separate it from your application form.

We would appreciate it if you could fill in all sections of this form. However, it is not compulsory to fill in this form or to answer all of the questions – whether you do so will not affect your chances of being shortlisted or selected for the post in any way.

Post for which you are applying:
Where did you see this advertised:
Are you female or male?
Date of birth:
Ethnic identity (however you would describe it):
First language:
Do you have a disability?
Sexual orientation (as you would describe it)
Do you feel DVIP’s recruitment procedure has discriminated against you in any way? If so, please tell us how: