Please return completed form by email to
Email to -
Please type this form to enable clear photocopying.
Please read the guidance notes, job description and person specification before completing this form. Short listing for interview will be carried out solely on the basis of information provided on this application form. It is therefore essential that you complete the form fully and that you clearly demonstrate how you meet each point/criterion on the person specification.
Please do not return the Recruitment - Additional Notes it is for your information.
A. YOUR DETAILS:
Position applied for:
Your full name including title:
Contact telephone: May we contact you on this during work hours YES/NO
Email address:
Contact Address:
Post Code:
Are you eligible for work in the UK
Are you related to a current member of staff
Are you available on the scheduled interview date? (yes/no):
If offered this appointment when would you be free to start? (date):
EDUCATION AND TRAINING
Please list any education and/or training, particularly job related training (including short courses) that you have undertaken. Please write most recent first:
DATES / EDUCATION/TRAINING/COURSES / QUALIFICATIONS
REFERENCES:
Please give below the name and address of two referees who can comment on your suitability for the post. These should not include relatives or purely personal friends. If you have been employed we would normally seek a reference from your present or most recent employer.
Referee one – existing or most recent employer: YES/NO
Referee’s name:
Relationship to you (eg: line mgr):
Organisation employed by
Job title:
Email address:
Contact telephone:
Address:
Can we contact before the interview (yes/no/when):
Referee two:
Referee’s name:
Relationship to you (eg: line mgr):
Organisation employed by (if relevant)
Job title:
Email address:
Contact telephone:
Address:
Can we contact before the interview (yes/no/when):
PAID AND/OR UNPAID WORK EXPERIENCE:
Please include your current/previous employment (including job training schemes), voluntary work. Community activities, school/college placements, time caring for dependants etc. Please put in date order, starting with your most recent. Continue on a separate sheet if necessary.
Dates and Job Title / Employer/Organisation / Nature of Work/Main Responsibilities / Salary/Reason for Leaving
SUPPORTING INFORMATION
In this section we would like you to give specific information in support of your application, taking each point of the person specification, demonstrate how you have all the necessary skills and abilities. Please note that there may be more or fewer points on the person specification than are listed on this form. If there are more boxes please add more boxes and if there are fewer delete the boxes you do not use.
1.2
3.
4.
5.
6.
7.
8.
9.
Have you ever been involved in proceedings against you in either a civil or criminal court?
Yes / No
If YES, please give details below and please include those offences which
are not yet “spent” or have not expired (as per the Rehabilitation of Offenders Act 1974 for applicants within the UK):
Have you ever committed an offence under sections 25 and 26 (1) (d) or (g) of the Immigration Act 1971? YES/NO (please delete as appropriate)
(For further information please refer to the ‘Notes for applicants’ sent with this form.)
Data Protection Act 1998
As part of the recruitment procedure we may collect and store sensitive personal data about you. We are required by law to obtain your consent to such data being recorded. It is our policy to store data relating to recruitment procedures for 12 months after the date, on which it is submitted, for internal auditing purposes. Any information of this nature will be treated confidentially.
Sensitive personal data is defined as information relating to any of the following: racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences and/or convictions. I acknowledge that by signing this form I give my consent to sensitive personal information being recorded and stored. For the purposes of the Act the Data Controller is Birmingham Citizens Advice Bureau Service Ltd
I declare the information given on this form is correct to the best of my
knowledge and can be treated as part of any subsequent Contract of Employment. I understand that I may be liable to dismissal without notice if the information is subsequently found to be untrue or deliberately misleading.
Signature ______Date ______
In confidence
EQUALITY OF OPPORTUNITY : Birmingham CAB Service
Birmingham CAB Service operates an equal opportunities policy. To help us monitor the effectiveness of this policy, you are requested to complete this form and return it with your application. A statement of policy has been included in the recruitment pack.
This information will be separated from your application as soon as it is received; it will not be passed on to anyone involved in shortlisting or appointment to this post.
Post applied for:
Please tick the appropriate boxes below.
Do you currently work for Birmingham CAB Service Ltd? Yes No
What is your sex? Male Female
Would you describe yourself as having a disability? Yes No
If yes, are you registered as disabled? Yes No
Please tick the box from the following list which best describes the ethnic category to which you belong:
White Mixed
British White and Black Caribbean
Irish White and Black African
Other White White and Asian
Other Mixed
Asian or Asian British Black or Black British
Indian Black Caribbean
Pakistani Black African
Bangladeshi Other Black
Other Asian
Chinese or other Ethnic Group
Chinese
Other Ethnic
To help us monitor our advertising policy, please say where you saw this post advertised /FOR OFFICE USE ONLY
Ref No......Shortlisted
Appointed
RECRUITMENT – ADDITIONAL NOTES
1. DBS Check
Please do not send this form back with your application form, it is for your information only
In accordance with Citizens Advice national policy we will ask the successful candidate to be screened by the Disclosure & Barring Service. However a criminal record will not necessarily be a bar to your being able to take up the job. However if you have been convicted of a sexual offence against a child or vulnerable adult you will not be able to work in the CAB and the job offer will be withdrawn or your probationary period ended. For other offences it will be a matter of discretion depending on various factors.
If a successful applicant already has a recent Disclosure, we would require a new DBS Check to be undertaken if the Disclosure Certificate is more than six months old, or if the client group has changed from vulnerable adults to children, or if the bureau has decided that the post requires an Enhanced Disclosure.
Birmingham CAB Service “Risk Assessment in Recruitment Policy” can be supplied on request.
2. Notes for applicants on completing the application form
The form should be typed. This will make it easier for photocopying purposes.
Please do not send in your CV. It will not be considered if you do.
One of your referees should be your present or most recent employer. If you have not been employed or have been out of employment for a long time, please give the name of someone who knows you sufficiently well to confirm the information you have given and to comment on your ability to do the job. This should not be a relative or a purely personal friend.
The enclosed person specification lists the minimum requirements for this post. When shortlisting for interview the selection panel will only consider the information contained in your application form and will assess only the information you have supplied here, against the person specification.
The selection panel cannot make assumptions about the nature of the work you have done or your experience from a list of job titles. It is therefore important that you use the space provided to demonstrate how the work and experience you have gained meets the requirements of the role. Paid and voluntary work are not the only experiences worth quoting. Other life experiences and skills may be just as valid.
If you are shortlisted for interview, the selection panel will ask you questions based on the person specification which will cover the areas in more detail.
The following applies only to advisers, and not to other posts. Sections 25 and 26 (1) (d) or (g) of the Immigration Act 1971 are concerned with the following offences: assisting illegal entry, falsifying documentation or obstructing the authorities investigating immigration offences. If you have committed one of the offences above you may still be able to be an adviser; however, we would have to contact the Office of the Immigration Services Commissioner in order to discuss the issues.