Wylde Green Nursery School

Name ______

Position Applying for ______

Date form completed ______

Wylde Green Nursery School

23-27 Green Lanes

Wylde Green

Sutton Coldfield

B73 5JL

0121 350 8020

Please ensure you fully complete all sections of this application form putting N/A for any sections not applicable to you, if forms are not fully complete they may not be considered.

Application Form

Position applied for ……………………………………………..

Available to take up employment ……………………………..

Prepared to work:

Full time___

Part time___

Personal Details

Mrs ___ Miss ___ Ms ___ Mr ___

Surname…………………………………………………….

Forename (s)……………………………………………….

Address…………………………………………………………………………………………………………………………………………………………………………………..

Postcode……………………………….

Telephone………………………………………..

Mobile…………………………………………….

Email ……………………………………………..

Education & Training (please give details of education and any further training courses attended, stating qualifications and results)

Education/training courses attended (starting with secondary education then further education) / Examinations taken / Results/Qualification achieved / Date

(Continue on a separate sheet if necessary and attach to your application)

Employment History

Place of Employment / Dates employed from and to (day/month/year) / Position and brief description of your duties / Reason for leaving

(Continue on a separate sheet if necessary and attach to your application)

Gaps in employment

Please tell us about any gaps in your employment history. Please note you may be asked about these at interview.

From / To / Reason

Supporting statement

The supporting statement provides you with an opportunity to tell us more about yourself and your suitability for the role. Please tell us how you meet the requirements listed in the person specification. Please use as many examples as you can under each requirement, referring to your current and previous employment, voluntary, training or other relevant experience. (Please use a separate sheet if necessary and attach it to your application, please include your name on the attached sheet)

______

Permission to work in the UK

1.  Are there any restrictions to your residence in the UK that might affect your right to take up employment in the UK?

Yes _____ No _____

2.  If you are successful in your application would you require permission to work in the UK?

Yes _____ No _____

Essential information

This post is subject to the condition of an enhanced DBS check, please complete the following details:

1.  Have you ever been convicted of an offence?

(Declaration subject to the Rehabilitation of offenders Act 1974)

Yes _____ No _____

If yes please give details: ______

2.  Do you have police proceedings impending or outstanding against you?

Yes _____ No _____

If yes please give details: ______

3.  Are you disqualified by association?

Yes_____ No______

If yes please give details:

______

______

4.  Do you have any current Disciplinary warnings?

Yes _____ No _____

If yes please give details: ______

References

Please provide details of three people who can provide a written reference. If you are (or have recently been) employed in either paid or unpaid capacity, one reference MUST be from your current or last employer. If you are a student one should be from a senior staff member form your place of study. References from a relative or partner are not accepted.

(1) Full Name ______

Job title ______

Capacity known to you ______

Full Address (Inc post code)

______

Telephone:

Email:

May we contact prior to interview? Yes _____ No _____

(2) Full Name ______

Job title ______

Capacity known to you ______

Full Address (Inc post code)

______

Telephone:

Email:

May we contact prior to interview? Yes _____ No _____

(3) Full Name ______

Job title ______

Capacity known to you ______

Full Address (Inc post code)

______

Telephone:

Email:

May we contact prior to interview? Yes _____ No _____

Additional Personal Details
Applicants are requested to tick the relevant boxes below to enable the organisation to monitor its equal opportunity policy. Monitoring is recommended by the Codes of Practice for the elimination of racial discrimination and for the elimination of discrimination on the grounds of sex and marital status. This information is used for no other purpose and will be treated as confidential.
White – British Mixed – White and Black Caribbean Asian/Asian British – Indian
White – Irish Mixed – White and Black African Asian/Asian British – Pakistani
White – Other Mixed – White and Asian Asian/Asian British – Bangladeshi
Mixed – Other Other Asian Background
Black/Black British – Caribbean Chinese
Black/Black British – African Other
Black/Black British – Other Male Female
National Insurance number
Recruitment Policy
It is the organisation's policy to provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person because of race, colour, national origin, sex, sexual orientation, religion or belief, marital status, age or disability or age.
Declaration / I confirm that the information given on this form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection or, if employed, dismissal.
Signature
Date

Please return this application and any additional information to:

My First Friends Day Nursery

Ashbrook Drive

Great Park

Rubery

Birmingham

B45 9FP

1 September 2015