APPLICATION FOR EMPLOYMENT
In ConfidenceNo:……………..
Please complete in black ink or typescript. Please do not send in your Curriculum Vitae.
Post applied for:
Where did you see the post advertised?
1 Personal Details
Family name:First Name:
Address:
Postcode:
Work tel. No.:Home tel. No.:
Work email:Home email:
May we phone/email you at work?Please tick the relevant boxes YES NO Email: YESNO
2 General
Do you have a full and current driving licence?YES NO
Is it clean?YES NO If no, please give details.
3 Medical Details
Have you had any serious illness in the last two years? If so, please give brief details:
How many days have you had off work due to sickness in the last two years?
Please show on the continuation sheet at the back of this form details of absences from work due to sickness exceeding one week in the last five years. Any offer of employment will be subject to satisfactory health clearance.
4 References
Please give the names, addresses and telephone numbers of two people whom we may apply to for references:
Reference 1(Present or most recent employer)
Name:
Address:
Telephone No:Occupation:
Email:
Capacity in which known:
May we contact this referee prior to interview? YESNO
Reference 2
Name:
Address:
Telephone No:Occupation:
Email:
Capacity in which known:
May we contact this referee prior to interview? YESNO
References will normally be sought for all short listed candidates after interview.
5 Availability
Are you available on the proposed interview dates?YES NO
If successful, when would you be available to take up a new appointment?
6 Present Employment (Or, if now unemployed, details of last employment)
Employers name:
Address:
From:To:
Job title:
Current salary:£
Please give a brief description of your present job.
Please give your reason for seeking new employment.
7 Previous Employment (Continue on the back of this form if necessary)
Please give details of your previous paid or unpaid work or any other relevant experiences that you would like to mention, starting with the most recent:
From – To / Employer / Salary / Job Title/Duties / Reason for Leaving8 Potential Conflicts of Interest
Do you have any commitments which make demands upon your time or any relationships which have the potential to represent a conflict of interest with the job you are applying for?
YES NO
If yes, please give brief details.
9 Education and Qualifications
Please list any relevant qualifications obtained:
Period of StudyFrom – To / Subject / Class/Grade Result / Qualification Obtained & Name of Institution
Professional Qualifications Held
Professional Body:
Level of Membership:
Date of Registration:
By Examination or Election?
10 Disabilities
Do you consider yourself to have a disability? YES NO
If you feel that you have a disability, are there any arrangements which we can make for you if you are called for interview? Please give details below.
11 Other Information (Please use extra sheets as necessary)
Please write a statement outlining why you are applying for this role and addressing how you meet the requirements outlined in the person specification.
12 Criminal Record Declaration
Surname: / Forename:This post is not exempt from the Rehabilitation of Offenders Act 1974. We only ask applicants to disclose convictions which are not yet spent under the Rehabilitation of Offenders Act 1974. If you are not sure whether your convictions are spent please contact Nacro for further advice (
Do you have any unspent convictionsYESNO
If you have answered yes, you now have two options on how to disclose your criminal record.
Option 1: Please provide details of your criminal record in the space below:
Option 2: You can disclose your record under a separate cover provided that you mark a cross on the line below and attach the details in an envelope stapled to this form. The envelope should be marked ‘Confidential’ and state your name and the details of the post you are applying for.
I have attached details of my conviction(s) separately ______(mark a X if appropriate)
Have you ever been the subject of any investigation/enquiry into inappropriate behaviour in relation to children, young people or vulnerable adults?
YES NO
If yes, please provide details.
I declare that the information provided on this form is correct. I understand that the declaration of a criminal record will not necessarily prevent me from being offered this role at Brighton Oasis Project.
Signed: …………………………………………Date: …………………………………
Please return this form with your application form.
13 Declaration
NOTES TO ALL APPLICANTS
1.In accordance with the Asylum and Immigration Act 1996 Section 8, if you are invited to attend an interview you must provide an original document which states your National Insurance Number e.g. P45, P60, Payslip or a National Insurance Card and confirms your eligibility to work in the UK.
2.The post will be subject to a satisfactory Enhanced Criminal Records check, Occupational Health Clearance and receipt of satisfactory references.
3.We welcome applications from people with previous problematic drug or alcohol use. Applicants must currently be free from illicit substances and not using alcohol problematically.
Please sign the declaration below:
I declare that I am drug free and I am not using alcohol problematically. The particulars that I have sent out on this application form are true in all respects. I understand that the provision of false information may result in disciplinary action which could lead to dismissal.
SIGNED …………………………………………………………………… DATE …………………….
When complete this form should be returned together with the completed Equal Opportunities Monitoring Form to:
By Post To:
PA to the Director/Administrator
Brighton Oasis Project
Globe House
3 Morley Street
Brighton, BN2 9RA
Or Electronically To:
If you would prefer to receive this application form as a Word document by email please send e-mail to
If you would like to receive this in large print,
please call (01273) 696970.
Continuation Sheet
Please attach additional sheets if necessary. Please ensure they are securely attached and are clearly marked with your name and the post applied for.