Courtyard Youth Worker

Application Form

Complete each question in black ink.

1.PERSONAL DETAILS

Closing Date for Applications : 5pm 28 November 2014,

Full details of present or most recent post : ………………………………….…………...

…………………………………………………………………………………………………….

At : ………………………………………………………………………………………………..

Address : ………………………………………………………………………………………...

Notice Required : …………………………………….…………………………………………

Surname : ……………………………………………………… Title : ……….………

Christian/First Names : ………………………………………………………………………...

Address : ………………………………………………………………………………………...

…………………………………………………………….. Postcode : ……………………..

Home Telephone Number : ……………………………………………………………………

Mobile Telephone Number : …………………………………………………………………..

E-mail Address : ………………………………………………………………………………..

Work Telephone Number : …………………………………………………………………….

Do you hold a current valid driving licence? Yes No

Do you own a car? Yes No

Which roleswould you like to be considered for (tick all that are appropriate)?

Newcastle Upon Tyne (Cathedral Parish)

Farnworth (Bolton, Greater Manchester)

How did you hear about this job opportunity? ……………………………………………..

2.EDUCATION AND QUALIFICATIONS

Please give information about any education received in this country or abroad, in chronological order.

Secondary Education

Name of School/College / Date
From/To / Subject / Qualifications Gained / Grade / Date

Further Education

Name of College/University / Date From/To / Subject / Qualifications Gained / Grade / Date

Professional Qualifications

Name of Professional Body / Membership Grade / How gained (e.g. part-time, full-time) / Date

Qualifications being studied for

Name of College / Subject / Level / Expected date of Qualification

3.EMPLOYMENT HISTORY

Previous Employment (most recent first)

Name, Location and Nature of Employer's Business / Position Held / Date
From/To / Reason for Leaving

DETAILS of all other employment and unpaid experience after the age of 16, in chronological order, (for example : family duties, voluntary work etc.) which you wish to be taken into consideration:

Name and Address of Employer / Nature of Business / Responsibilities and Post Held / Reason for Leaving / Dates

If you wish to comment on any periods of unemployment in your work history, please do so here:

4.Supporting Statement

Please describe how you outlining how you match the person specification (a continuation sheet may be attached).

Application by video:You are encouraged to submit your supporting statement by video if you feel this makes best use of your skills. Videos should be no longer than 3 minutes and uploaded to a sharing platform with a link sent with this application form to .

5.REFERENCES

Please nominate up to three referees, one of whom should be your present or most recent employer. Please tick the boxes only if you do not want the referees to be contacted prior to interview.

(i)Name : ……………………………………………………………………

Occupation : …………………………………………………………………………….

Address : ………………………………………………………………………………...

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(ii)Name : ……………………………………………………………………

Occupation : …………………………………………………………………………….

Address : ………………………………………………………………………………...

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(iii)Name : ……………………………………………………………………

Occupation : …………………………………………………………………………….

Address : ………………………………………………………………………………...

…………………………………………………………………………………………….

When would you be free to take up this appointment? …………………………………….

Please complete and return by email to -

Danny Curtin

CEO Million Minutes

(All applications will be acknowledged within 24 hours. If you do not receive an acknowledgement, please assume we have not received your application).

BY 5pm ON : FRIDAY28 NOVEMBER 2014

Million Minutes 604a Commercial Road, London E14 7HS
millionminutes.org

Registered in the UK as a company limited by guarantee (number 7442390)
Registered office as above. Charity number 202918