/ LH56 / Application for Employment / Version No. / Date of last version
Function: Human Resources / 3.4 / Sep 15

APPLICATION FORM

For the post of:
LACE Housing Association is an Equal Opportunities Employer. It is opposed to discrimination on any grounds, and in particular on grounds of race, creed, nationality, disability, age, sex, sexual orientation or responsibility for children or dependents.

Completed forms should be returned to contact name/email given or via

LACE HOUSING LTD, ‘LACE HOUSE’, 2 OLSEN RISE, LINCOLN, LN2 4UZ

 01522 51444401522 560689

CONFIDENTIAL ALL QUESTIONS ON THIS FORM MUST BE ANSWERED

1. Personal Information
First Names / Surname
Title(please tick) / Mr / Mrs / Miss / Ms / Date of birth
Address
Postcode
Contact numbers: Mobile / Home
When and where is the best time to telephone you?
Email address:
National Insurance no.
Details of dependents
Do you hold a current driving licence? / Yes / No / If Yes, do you have endorsements? / Yes / No
If Yes, please give details:
2. Education and Training / Please give us as much detail as you can, (additional sheets may be added if needed).
e.g.
Dates from/to Secondary school/college/university Qualification gained
2. Education and Training (continued) / e.g., apprenticeships, on-the-job training, software skills, etc.
We value skills obtained from all work experiences please complete this section if appropriate
Please include details of your special interests, sports and hobbies including positions of responsibility
Date joined Name of Professional or Technical Association Status
Give details of other recent courses attended (with dates):
3. Practical Training
4. Other Experiences e.g. voluntary/holiday/vocational
5. Additional Information
What particular elements in a job do you most enjoy?
What do you consider you might contribute to the job applied for?
What elements of a job do you least enjoy or find difficult and why?
6. Employment - We require you to give us details of your two most recent employers both of whom we may contact
Employer (1)
Name and address of PRESENTorMOST RECENTemployer:
Position Held: / From: / To:
Salary and main benefits:
Notice required (if applicable):
Give a brief description of the job responsibilities:
Why do you wish to change your employment or reason for leaving?
Employer (2)
Name and address of employer before the above:
Position Held: / From: / To:
Salary on starting: / Salary on leaving:
Reason for leaving:
Your last job title and main responsibilities:
7. References
Please give the full names and addresses of two referees who have given permission for their names to be used. You must give your current or most recent employer. Referees must be people who know/have known you in paid or unpaid work or educational environment. Personal relations/friends/colleagues are not acceptable.
First Referee / Second Referee
Name / Name
Address / Address
Post Code / Post Code
Telephone / Telephone
Position/Title / Position/Title
We are obliged to seek permission from our Board of Management if we wish to engage someone who is a close relative of one of our present or past employees. If you have any close relatives who are currently working for LACE Housing or who have worked for LACE Housing in the last twelve months, please give details below. This information will not affect the selection.
Are you aware of any health conditions or disability which might impair your ability to fulfil any role offered? / Yes / No
..If Yes, please indicate below any conditions or requirements we should consider when offering a suitable placement/role below. All health information given will be treated in strict confidence:
The post you are applying for is exempt from the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. You are therefore not entitled to withhold a convictions which would otherwise be regarded as ‘spent’ but must disclose them, unless they are “protected” by the 2013 amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975
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) / Yes / No
IF YES, PLEASE PROVIDE DETAILS BELOW(continue on separate sheet if necessary)
Date of offence / Nature of offence / Place where it occurred / Name of the court / Penalty Imposed
Are you registered with the Disclosure and Barring Service (DBS) or do you have a current Police Check Certificate which covers the last twelve months? / Yes / No
Have you ever been subject to any complaint, dismissal or disciplinary procedurethat was the subject of a Police Investigation or Local Authority Safeguarding Investigation? / Yes / No
..If Yes, please give details:

DECLARATION

  • The information provided in this application is true and correct and I understand that any deception or false entry may result in dismissal if offered employment.
  • I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organisations for furnishing such information.
  • I give consent for the employer to confirm my registration with the Disclosure & Barring Service (DBS) and register an interest in order to receive updates about this registration.
By signing below I confirm the above declaration:

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

Page 1 of 6