Cerebral Palsy Sport is an equal opportunities employer

National Sports Development Officer

APPLICATION FORM

Please return this form to:Chief Executive, Cerebral Palsy Sport, 5 Heathcoat Building, Nottingham Science Park, University Boulevard, Nottingham, NG7 2QJ or email the application to

Personal Details (Please print clearly)
Surname
Forenames
Any Surname previously known by
Address
Post Code
Telephone (home)
Telephone
(business)
Email
May we contact you at work?
Do you have a full driver’s licence?
Does your licence have any current endorsements? If Yes, please give further information:
Education and Qualifications
Name(s) and Address(es) of School(s)/College(s) / Dates / Subjects/Courses Studies and Level
Examination
Results

Further and Higher Education: please give details of all further and higher education since leaving school including training courses and details of qualifications

University/College / Dates / Subjects studied – Examinations taken – Results (Hons/level attained)

Other Continuous Professional Development or Memberships of Professional Associations

Employment History
Please list all your previous posts, starting with the most recent. Please use additional sheet if required.
Present or last employer, name and address, type of business:
Dates employed:
Position(s) held:
Brief description of duties:
Reason for leaving (if appropriate):
Current salary: £
Notice required:
Previous employer, name and address, type of business:
Dates employed:
Position(s) held:
Brief description of duties:
Reason for leaving:
Previous employer, name and address, type of business:
Dates employed:
Position(s) held:
Brief description of duties:
Reason for leaving:
Any other information relevant to your application (for example, skills, reasons for suitability)Pleaseuse a separate sheet if necessary
If you require any particular arrangements when attending an interview, please give details
NAMES AND ADDRESSES OF TWO REFEREES

Please give the names and addresses of two referees who are not related to you, who we can approach for a confidential assessment of your suitability for this job (one of these must normally be a previous employer).

Can we approach your present/most recent employer?

Name, Position, Address and Telephone Number and email Address / Name, Position, Address and Telephone Number and email address
Email: / Email:
DECLARATIONS OF APPLICANT
Do you have any convictions, cautions, reprimands or final warnings that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?*

*Note:

The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers , and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.

I understand that any potential employment will be offered subject to a Disclosure and Barring Service Check and that in the event that this Declaration is found to be false that my employment may be terminated immediately.

I declare that the information given on this form is, to the best of my knowledge, correct and gives an accurate representation of my application and employment history.

I understand that the information provided will be used to make a decision regarding my suitability for employment and, if successful, the information will be used to form my personnel record and will be retained for the duration of my employment as long as is deemed necessary thereafter.

I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable for dismissal.

Signature: ……………………………… Date:………………………..

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