EMP. 15
APPLICATION FORM SUSSEX HOUSING & CARE Ronald Simson House
CONFIDENTIAL24 Sutton Avenue
Seaford
East Sussex BN25 4LG
Form Number:
Tel: 0845 4023702
It is important that you read the Guidance Notes enclosed Fax: 0845 4023701
before starting to complete this form. The form is available
electronically on request.
Job applied for: …………………………………………………….………. Job Ref: …………………………………..
How did you hear about this vacancy? …..……………………………………………………………………………………......
Are you permitted to work in the United Kingdom? Yes No (please tick as appropriate)
.1.ABOUT YOU……………… ……………… ……………… ………
Last Name: ……………………………………………………First name/s: ………………………………………..
Home Address: ……………………………………………….Home Tel. No.: ……………………………………..
……………………………………………………………………Mobile tel. No.: ……………………………………..
Postcode : …………………………………………………….. E-mail: ……………………………………………….
Work Tel. No. : …………………………………………………National Insurance No.: ……………………………
May we ring you at work?Yes No
Please tick to confirm that you meet any regulatory age requirement stated in the job advertisement or person specification
(if no age requirement has been indicated, please leave blank)
Are you related to, or do you reside with, any present or former Board members or employees of Sussex Housing and Care? Yes No
If yes, please give details: ……………………………………………………………………………….……………………………………
Do you have a full Driving Licence that allows you to drive in the UK?Yes No
Do you have access to a car that you can use for work, as necessary?Yes No
If you have been banned from driving, or have any current endorsements on your licence, please give details:
………………………………………………………………………………………………………………………………………….………….
.2.YOUR REFERENCES ……………… ………………… ………
Please provide details of two referees. We require references from your line manager/supervisor in your current and previous employment, covering at least the past 3 years. One must be your most recent employer. If the reference details you provide are not satisfactory for our purposes, we may need to discuss with you the possibility of taking up other references. References will only be taken up for successful candidates
Name: ………………………………………………..Name: ………………………………………………..
Job Title: ……………………………………………..Job Title: …………………………………………….
Organisation: …………………………………………Organisation: ………………………………………..
Address: ……………………………………………...Address: ……………………………………………..
…………………………………………………………..………………………………………………………….
………………………….… Postcode: …………………………………………… Postcode: …………….
Tel No.: ………………………………………………..Tel No.: ………………………………………………
Capacity in which they know you (e.g. line manager)
…………………………………………………………….…………………………………………………………
.3.YOUR EDUCATION AND TRAINING ……………… ………
Please give information about qualifications gained during your secondary, further and adult education stating whether it was undertaken on a full or part-time basis.
Qualification Date Gained Awarding Body
If you have undertaken any training or development to improve your employment prospects, please give details if you think that they may be relevant
If you are a member of a professional, trade and/or vocational organisation, please give details
.4.YOUR EMPLOYMENT BACKGROUND ……………… … ………………
Current/most recent job
Employer Job Title Salary/Benefits From/To Reason for Leaving
Please describe briefly this job:
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How much notice does your present employer require? ……………………..……………………………………………………………
Previous jobs (paid and voluntary), with the most recent listed first. Please indicate the reasons for any gaps e.g. continuing education, family or child care, unemployment, etc.
Employer Job Title & Duties Salary/Benefits From/To Reason for Leaving
.5.YOUR HEALTH (see also “Disability” and “Equal Opportunities”) … ………
How much sick leave have you taken in the last 2 years? …………………………… (days) on ……………………. occasions.
Reasons: …………………………………………………………………………….………………………………………………………….
Please give details (including dates) of any other illness/operation/disability or injury which could affect your ability to perform your duties, including any injury or disability which may prevent you from lifting objects.
This information is needed so all applicants who have a disability and meet the minimum criteria for this position are offered an interview. We will contact interviewees to discuss any special arrangements.
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.6.FURTHER INFORMATION ………………… ……………… ………
Please make use of this space to give us any further information about your suitability for this job, and any other experiences you feel are relevant e.g. any voluntary work. Please tell us why you are applying for this job and how you think your skills, knowledge and experience make you suitable. If necessary, please feel free to submit an additional sheet. N.B. Please refer to the Guidance Notes.
If you are unsuccessful in this application, we will keep this form on file for 6 months and may consider you for other vacancies within the organisation. Please tick if you agree/disagree Yes No
If you have previously applied to us for work, say when: ……………………………………………………………………….…………
What was the job? ……………………………………………………………………………………………………………….……………..
Were you interviewed? YesNo
Have you ever been the subject of formal disciplinary action in the past?YesNo
If Yes, please give details:
Date/sEmployerSubject Outcome
This post is exempt from the provisions of section 4(2) of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. It is therefore necessary for you to answer the following question.
Have you ever been convicted of any criminal offence by a court of law, including being subject to any conditional discharges, bindovers or cautions? Yes No
If Yes, please give details:
DatePlaceOffence Sentence
Enhanced level CRB (Criminal Record Bureau) disclosure and POVA (Protection of Vulnerable Adults) register checks apply to most positions (please see further information about the vacancy). I certify that the information given in this application is true and accurate to the best of my knowledge. I also understand that if I am appointed to this post and the information given is subsequently found to be false, I may be liable to dismissal. If I am successful in my application, I agree to the references (as stated on the front page of this application) and appropriate level CRB check and POVA check being requested.
Signed: …………………………………………………..………………..Date: …………………………………………..
(N.B. : If you are returning this form by e-mail, you will be asked to sign the application form if you are selected for interview – to confirm the information supplied is true and accurate)
.GUIDANCE NOTES…………………………………… ……… … ……
CV’s will not be accepted as a substitute for a fully completed application form.
The application form plays a vital role in the selection process, both in deciding whether or not you will be shortlisted for interview, and as a basis for the interview itself. It is therefore important to address the person specification by relating it to your experience, knowledge, skills and abilities, which are relevant to the job.
The following advice should help you to complete the application form as effectively as possible
1.The Job Description
The job description details the sort of duties you would be expected to carry out. Ask yourself why you are interested in the job and whether it would be a good career move. Ask yourself whether it would broaden your general work experience or support the sort of work you might want to undertake as a career ( and whether you can you support this)
2.The Person Specification
This document will list the skills, knowledge, qualifications and experience required. You should provide evidence of these in your application. It may be helpful to explain your present and previous jobs to someone else and uncover “hidden” skills that perhaps you have taken for granted. Consider any relevant experience you have acquired outside the work environment e.g. at home, in the community or because of your voluntary or leisure interests, for example.
3.Your Employment History
Write out your career history. Don’t go into too much detail but make sure that you explain the main features of the most relevant jobs that you have had. Check that the details are correct and in the right order. Make sure that there are no gaps. Use another sheet of plain paper if there is not enough room on the form. Put a tick in the relevant box if you are being asked a Yes or No answer.
4.Do a Rough Draft First
Look through the form first and write out your proposed responses in rough to avoid mistakes, repetitions, etc. This will also give you the opportunity to make sure that your responses are well organised and relevant.
5.The “Other Information” Section
This is where you could make your case for the job, so gear your application to the job. You should refer to the person specification and try to provide evidence of how you meet each requirement. Your responses should be written legibly and in a concise, well organised and positive way e.g. use active words like “I organised..”). Specify your own personal responsibilities rather than those of your organisation or company.
6.Completing the Form
Type it or use black ink/ball point. Ensure it is clearly presented in order to create the best impression.
7.Health Questions
Make sure that you answer all the questions.
8.Convictions
It is vital that this declaration is completed. A criminal record will not necessarily be a bar to obtaining a position.
9.Sign the Form
This can sometimes be overlooked so double-check before you send the form in. Once signed, keep a copy for your own records.
10.Send the Form in on Time
Send your completed form to the relevant address (see the first page of the form, unless there are other specific instructions) to allow it time to bereceived before the specified closing date. Mark the envelope “Private and Confidential”, or E-Mail it to , marked “Application – Confidential”
DIVERSITY AND EQUALITIES………………………………… ……………………………………
The Association is an equal opportunities employer and is committed to employment policies which do not discriminate on grounds of race, colour, nationality, ethnic or national origin, disability, gender, religion, age, marital status, sexual orientation or medical condition (including people living with HIV or AIDS). For this reason, recruitment and selection procedures have been adopted which aim to avoid any unfair discrimination on these grounds during consideration of applicants for employment. To help us monitor this Policy and the effectiveness of our recruitment practices, we ask you to complete the following questions. As with all the other information you provide on this form, it will be treated as confidential.
Ethnic Origin………………………………………………… …………………………… …...
We examine applications regardless of your ethnic or racial origin. In the box provided, please enter the corresponding number which you believe best describes your ethnic origin.
1.White: British10.Asian/Asian British: Bangladeshi
2.White: Irish11.Asian/Asian British: Other
3.White: Other12.Black/Black British: Caribbean
4.Mixed: White and Black Caribbean13.Black/Black British: African
5.Mixed: White and Black African14.Black/Black British: Other
6.Mixed: White and Asian15.Chinese
7.Mixed: Other16.Other
8.Asian/Asian British: Indian17. Not known
9.Asian/Asian British: Pakistani18.Undisclosed
Disability………………………………………………………………………… …… ...
If you have a disability and are qualified/experienced or otherwise suited for the job, it will not influence our attitude towards your application.
Do you have a disability?YesNo
IfYes, please give brief details: ……………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………….
Gender & Sexual Orientation…………………………………… …………
Your gender will not influence our attitude towards your application.
Are you Female Male
How do you regard yourself :HeterosexualBisexual Lesbian/Gay
Age…………………………………………………………………… ……………...
Your age (providing it is between 18.0 and 64.5) will not limit our consideration of your suitability.
Age: ………………………Please state your date of birth: ……………………………
Please be assured that this information is not required as part of the selection process and will not be made available to those persons assessing candidates and making decisions on appointments. This section will be separated prior to shortlisting.
Form Number: