Reference (office use only) ______

APPLICATION FORM
Post applied for:-

IMPORTANT: Please complete this form using block capitals and dark ink or on a computer. If you are completing this form electronically, please remember to also return a signed paper copy to DTA Wales.

SURNAME:
FORENAMES:
HOME ADDRESS (please also state address for correspondence if different):
CONTACT DETAILS:
Telephone contacts: / Daytime:
Evening:
Mobile:
E-mail:
EDUCATION, QUALIFICATIONS & TRAINING COURSES COMPLETED
Include any examinations which you are about to take or awaiting results and training courses which you feel are relevant.
Name of school, college or
training provider / Dates / Subject / Qualifications
EMPLOYMENT HISTORY
PRESENT EMPLOYMENT (if applicable)
Main areas of responsibility & experience gained / Date appointed / Name & address of employer / Reason forleaving
PREVIOUS EMPLOYMENT
Please list your most recent employment first and include voluntary or unwaged work as appropriate.(Continue on another sheet, if necessary).
Position & responsibilities / Dates
(from & to) / Name & address of employer / Reason forleaving
REASONS FOR APPLYING FOR THIS POST
Please statewhy you are applying for this post(continue on another sheet – no more than one side of A4 – if necessary).
RELEVANT SKILLS, KNOWLEDGE AND EXPERIENCE
Give details of your skills and experience (including unwaged) which are directly relevant to this post. Please refer to the enclosed Job Description & Person Specification as appropriate. You may extend this section by no more than 2 sides of A4. Do not attach CVs, examples of work or any further supporting information; they will not be used to assess your application. If you use extra sheets, please make sure you put your name on them.
PERSONAL QUALITIES AND INTERESTS
Please state briefly the personal qualities and attributes or interests that you consider would help in this post.
REFEREES
Please give the name, address and telephone number of two referees. One should be your current/latest employer if applicable, who will be required to submit a reference on headed paper.
1. / 2.
START DATE
If you were selected, when could you start? Please give period of notice and details of any booked holidays if applicable.

Do you hold a full driving licence? –yes/no Do you own a car –yes/no

[ring the correct answer]

WHERE DID YOU SEE THIS POST ADVERTISED?

On Line (which site) / Other (please specify)
DECLARATION
I hereby declare that the information I have given is accurate and complete.
Signature of Applicant Date
Please return the completed form to:
Development Trusts Association Wales, 17 West Bute Street, Cardiff Bay, Cardiff CF10 5EPor

Development Trusts Association: Equal Opportunities Monitoring Form

Please assist us in monitoring the effectiveness of our equal opportunities policy by answering the questions below and returning this with your application form. Please note that the form will be detached from your application form immediately on receipt and will not be identified to you in any way. Your application will not be affected if you choose not to complete it.

Please tick the boxes:

1. What is your gender?

 female male

2.What is your age?

3.Which of the following best describes your racial or cultural origins?

 White British Black British

 Irish Other European

 Caribbean African

 Indian Pakistani

 Bangladeshi Chinese

 Other (please describe) ______

4.Do you consider yourself to be disabled?

 yes no

If YES, how would you describe your disability?

______

______

______

______

Thank you for completing this form