Dates (from/to) / Employer name and address / Job Title / Wage / Reason for leaving
Current notice required
2. Educational qualifications/relevant training courses
Name of school/college / Qualifications achieved / Date from / Date to
Vocational TrainingCourse / Certificated / Date from / Date to
4. Volunteering
Please list below any volunteering work you may have carried out.
The next question relates to your ability to do the job you are applying for. You need to give evidence to the recruitment panel that you have the relevant skills/experience to do the job.
Please relate your answers to the person specification, which was sent with this application.
5. Please tell us if you have, and howyou have acquired the relevant experience that the person
specification is asking for:
(Continue on separate page/s if needed)
6.Special interests/hobbies:
7.Reasons for applying for this post:
8. Further information in support of your application:
Application Form Part Two
This part of the application will be removed and not seen by any member of the recruitment panel.
(Please use block capitals)
NAME:Mr/Mrs/Ms
ADDRESS:
POSTCODE
CONTACT TELEPHONE NUMBER:
CONTACT Email address:
A. HEALTH DECLARATION:
If you have any health problems or disabilities which we need to take into account please tell us here:
Do you have a mental or physical disability? YES/NO
If yes please give details.
………………………………………………………………………………………
What adjustments may need to be made to the working environment to accommodate your disability?
…………………………………………………………………………………………….
Please give details of all absences from work in the last 12 months …………………………..
…………………………………………………………………………………………….
B Criminal Record
Please note any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974. If none please state:
………………………………………………………………………………………………………
C DATA PROTECTION NOTIFICATION:
(Please read this carefully before signing this application)
The information you have provided in completing this application form will be used to process your application for employment. The Company will keep the information you have supplied confidential and will not divulge it to third parties, except where required by law, or where we have retained the services of a third party representative to act on your/our behalf.
AUTHORISATION: I have read the Data Protection notification and understand and agree to the use of my personal data in accordance with the Data Protection Act 1998.
Signed:……………………………………….. Date: ……………………………………………..
D References:
After the post has been offered, and before it is taken up, RVA will write to the people whose names and addresses you insert here requesting information regarding your suitability for the post you have applied for. The first should be your current/last employer, or your last employer or Manager of any voluntary organisation you have worked with. The second referee should be someone, not related to you, who can give an opinion on your suitability for this post.
If you have not been in paid employment please give names of two people, not related to you, who can give an opinion on your suitability for this post.
1. 2.
EI confirm that theabove information is correct and that any false or misleading information will give my employer the right to terminate any employment contract offered.
Signed ...... Date ......
F I also confirm that I am legally entitled to work in the United Kingdom and if interviewed will produce one of the following documents from the list below:-
- a UK passport
- an EU passport or national identity card
- a UK residence permit issued by the Home Office
- an application registration card issued by the Home Office to an asylum seeker stating that the holder is permitted to take up employment
or two from the following:-
- an official document bearing a national insurance number along with:-
-a birth certificate, or
-a letter from the Home Office, or
-an immigration status document
- a work permit, along with:-
-a passport, or
-a letter from the Home Office
In either case, these must confirm the holder has permission to enter or remain in the UK and take the work permit employment in question.
Signed ...... Date ......
DATE RECEIVED: INITIALS:
SHORT-LISTED:YES / NO
APPLICANT INFORMED: LETTER/ TELEPHONE
INTERVIEW DATE:
RESULT:
APPLICANT INFORMED:
EQUAL OPPORTUNITIES RECRUITMENT
MONITORING POLICY
The Rother Voluntary Action (RVA) policy on equal opportunities requires fair and equal treatment for all job applicants, who are to be judged only on their ability to do the job for which they area applying. To help check the working of this policy RVA records the information given below – for statistical analysis and policy consideration only. These forms are detached from the application form as soon as the envelope is opened and processed by staff who have no involvement in either short-listing or interviewing of candidates.
Because of this and no other reason we would be grateful if you would complete the details below.
I am:MaleMy age is:
Female
21 & Under
I would describe my ethnic origin as:
22-30
European (Inc. British)
31-40
African/Caribbean
41-50
Asian
51-65
Other
Over statutory retirement age
Please state
I have a disabilityHow did this vacancy first come to your attention?
Yes
NoPress:
Which Newspaper?
Job Centre;
Internet
Community networks
Other:
Please state: