Registered Charity No. 1123267

Company Limited by Guarantee No. 6276431

Job Application Form

Development Officer (Children & Young People’s Lead)

Please complete all sections and return to:


or
Kay Smith
Community Action Wirral
220-224 Liscard Road
Wallasey
CH44 5TN
(Please mark “Private & Confidential”)

Please type or use black ink to complete this application

Personal Details

Title: Mr/Mrs/Miss/Ms /

Address for further communication:

Surname:
First Name(s):
Previous name(s):
if appropriate for reference purposes / Telephone Numbers
Home:
Work: Ext.
Mobile:
Education and Training
(Please list all education and training that you think is relevant to your application)

Dates

/ School/Higher education establishment / Qualification obtained or nature of training undertaken

Work Experience

Please provide details of work experience, whether in paid or unpaid employment, starting with the most recent.
Current Salary: £

Dates

/

Place of Work

/

Nature of Work

/

Reason for Leaving

Application
Do you hold a full British Driving Licence? Yes/No
Do you have access to a vehicle on a daily basis?Yes/No
Please provide any further information that you believe demonstrates your suitability for this post. In particular, provide information which demonstrates that you have experience in all aspects of the job and that you MEET THE ATTACHED PERSON SPECIFICATION. Attach extra sheets if necessary.
Knowledge and Experience
Abilities and Skills
Attitudes and Commitment
Additional
References
Please give the names of two referees who can comment on your suitability for the post. If you are in work, one referee should be your current employer. Tick the box if you do not wish your current employer to be contacted before interview (if appropriate) ٱ

First Referee

Name:
Company/Organisation:
Position Held:
Address:
Tel No. /

Second Referee

Name:
Company/Organisation:
Position Held:
Address:
Tel No.
Sickness History

How many days/occasions of sickness have you had over the last 2 years?

Declaration
I declare that the information contained in this form is true and complete. I understand that if it is subsequently discovered that any statement is false or misleading, Community Action Wirral has the right to dismiss me summarily from my employment. I understand that any offer of appointment may be subject to medical screening and/or examination.
Signature of Applicant
Date
Equal Opportunities
Community Action Wirral is striving to be an Equal Opportunity Employer.
Please complete and return the equal opportunities monitoring form.
Rehabilitation of Offenders Act 1974

Have you had any convictions, or do you have any prosecutions pending?

Please complete and return the rehabilitation of offender’s declaration.

Community Action Wirral Application Form 2014