Centre for Action on Rape & Abuse

JOB APPLICATION FORM

Please complete this form and email it to:

to arrive no later than 12 noon on Wednesday 11th May

We will disregard any CVs sent as, or in support of, applications

Applicants successful in obtaining an interview will be asked to sign their application forms

.

Position applied for: ISVA – Part-Time

Personal Information

Full name: ______

______

(please underline your surname or family name)

Address: ______

______

______

Telephone no: (Home) ______

(Work) ______

Email address:______

Education
Dates / Name and location of school/college attended / Exams passed/qualifications obtained / Level/grade
Professional Qualifications and Training
Dates / Type of training course and name/location of provider / Qualifications obtained / Level/grade
Employment history for the past 10 years – Please include any voluntary work undertaken and give reasons for gaps in employment
Dates / Name and address of employer / Job title, main duties, present/final salary / Reason for leaving/wanting to leave
Referring to the Person Specification, please show how your work experience (both paid and unpaid), skills and training help you meet the selection criteria for this post. You are required to address each point in turn, using the numbers given. It is important not to assume that your experience or qualifications speak for themselves. Applications not completed in this way will not be considered.
A decision on whether to interview you will be based on your ability to provide evidence of your suitability for the post. A final decision on selection for the post will be based on this form as well as on your interview and on your references. You may add additional sheets if you wish to continue your answer, but please do not include a CV or any other supporting documents, as these will not be considered.
Essential:
Desirable:
Further information
How did you hear about this post? ______
Are you able to attend for interview on Wednesday 25th May? ______
How long is the notice period for your present post? ______
Do you need any special arrangements to be made to allow you to attend for interview? Y/N
If yes, please specify ______
References
Please provide the names and details of two people able to provide a reference for you. One must be your current or most recent employer.
Reference 1
Name ______
Address ______
______
Telephone ______
Email ______
Occupation ______
Relationship to you ______
May we contact this referee prior to a job offer being made? Yes/No
Reference 2
Name ______
Address ______
______
Telephone ______
Email ______
Occupation ______
Relationship to you ______
May we contact this referee prior to a job offer being made? Yes/No
Declaration
I declare that the information I have given in this application is correct and true to the best of my knowledge and belief.
For electronic submissions, please tick box to confirm
Signature: ______
Date: ______
Equal Opportunities Monitoring Form

CARA is committed to equal opportunities in its policy of employment and service delivery.

Please assist us by filling in this form, which will be used solely for monitoring purposes.

Please tick as appropriate

1.Gender

Male

Female

  1. Age

20-30  30-40  40-50  50+

3.Ethnic Origin

White

British

Irish

Any other white background. Please specify______

Asian or Asian British

Indian

Pakistani

Bangladeshi

Other Asian background. Please specify______

Black or Black British

Black Caribbean

Black African

Other Black background

Chinese or Chinese British

Mixed ethnic background

Other ethnic background. .Please specify______

  1. Disability

Do you consider yourself to be a disabled person (ie have you a disability as described in the Equality Act 2010?)

Yes

No

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