No of Working Days Off Sick in the Last Two Years

APPLICATION FORM

Nursery Worker
/
Please complete this form in full in black ink or type and return it in accordance with the instructions at the end.

Contact Details

FIRST NAME (S)

SURNAME

TITLE

ADRESS

POSTCODE

TEL NO (HOME)

TEL NO (WORK)

TEL NO (MOB)

E-MAIL

No of working days off sick in the last two years

Education and training

Please include all schools and college attended, all courses and training undertaken, full and par-time and any home study.

School / College / Other

Dates

Exams passed, qualifications

Career history

Please list all of your significant activities (paid and voluntary) since leaving full-time education. Please start with your current/most recent job and do not leave any gaps. Please attach a separate sheet if necessary.

Dates / Organisation and Job Title / Main Responsibilities
Interest and Leisure

Why is this job for you?

Your suitability

Using the job description and person specifications as a guide please describe how your skills and experience match our requirement. Please attach ONE separate sheet if necessary.

Disclosure of criminal convictions

The job for which you are applying involves substantial opportunity for access to children. It is therefore exempt from the Rehabilitation of Offenders Act 1974. You are therefore required to declare any convictions or cautions you may have even if they would otherwise be spent under this Act. The management committee of the Mudchute Park & Farm is also required, under arrangements introduced for the protection of children, to check with the police for the existence and content of any criminal record of the successful applicant. Information received from the police will be kept in strict confidence and will be destroyed immediately the selection process is completed. The disclosure of a criminal record will not debar you from appointment unless the selection panel considers that the conviction renders you unsuitable for appointment. In making this decision the panel will consider the nature of the offence, how long ago and what age you were when it was committed and any other factors which may be relevant.
Failure to declare a conviction will disqualify you from appointment or result in summary dismissal if the discrepancy comes to light (car parking and speeding offences need not be declared). All the information will be treated in the strictest confidence.

Have you ever been convicted of a criminal offence? Answer YES or NO

If yes please give details of the convictions, date and subsequent sentence.
References
Please include the contact details of two referees, one of which should be your current or most recent employer. We will not contact your current employer without your agreement.
NAME
POSITION
ADDRESS
POST CODE
TEL NO
RELATIONSHIP
May we contact this referee straight away? YES NO
NAME
POSITION
ADDRESS
POST CODE
TEL NO
RELATIONSHIP
May we contact this referee straight away? YES NO

EQUAL OPPORTUNITIES

The Mudchute aims for equal opportunities for all in its operations. Applicants are considered on their suitability for the job.

Please complete and return the equal opportunities form with your application to

DECLARATION

I declare that all of the information given above is to the best of my knowledge correct, and I have not excluded any material information, which would be pertinent to my application.