Application Form for Cafe Supervisor

Closing Date:Wednesday 11th March 2015

Personal Details
Surname: / Tel (Home):
Tel (Mobile):
Tel (Work):
Email:
Are you eligible to work in the UK/EEA? Yes/No
Do you require a work permit to work in the UK? Yes/No
First name (s):
Address:
Current or Most recent Employment
Job title: Name and address of employer. Brief description of current or most recent duties / Date from:
Notice required: / Date to:
Reason for leaving:

For the sections below please continue on a separate sheet of paper if necessary

Previous Employment History (most recent first)
Employer / Job title / Salary/
Grade / Date from / Date to / Reason for leaving
Education including Professional Development
Secondary School/College/University / Dates
attended / Qualifications / Dates obtained
Training Courses Attended (most relevant)
Name of Course / Provider / Date Obtained
How many days sick absence have you had over the last two years?
References:
Please give the name and contact details of 2 referees (one to be current or last employer)
Referee / Current/last employer / Other
Name
Position
Address
Postcode
Phone
Email

Are you willing for your present employer to be approached before interview Yes/No

Rehabilitation of Offenders Act 1974

You are applying for a post classified as exempt from the Rehabilitation of Offenders Act 1974, you must state whether or not you have any convictions, criminal charges or summonses pending against you.

Disclosure

The successful applicant will be required to provide their written approval for Crownway Community Centre to contact the Criminal Records Bureau for additional information. Have you been convicted of any relevant criminal offences? Yes/No

If yes, please give details:

Data Protection Act 1998

I understand that by signing this form I give my consent for the information contained therein to be recorded. The personal information contained within this form will be held securely and in accordance with the Data protection Act for a period of one year after my application is submitted then disposed of securely and confidentiality.

Please sign and date this declaration:
To the best of my knowledge and belief the information given in this application is accurate. I understand that any false or misleading statement provided by me could result in my dismissal.
Signature:
Date:
/ Please return form to:
Crownway Community Centre
Crown Street
Earlestown
Newton-le-Willows
WA12 9DA
Tel: 01925 222907
Email:

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