Staff Application Form

Post Applied for: / Job Ref No:
PERSONAL DETAILS
Family Name: / Title
First Name(s)
Previous Family Name(s) (if any)
Sex / National Insurance No
Date of Birth / Marital Status
Current Home Address
Post Code
Home Telephone / Mobile Telephone
E-mail address:
(this will be used for all contact so please ensure it is correct)
Where did you hear of this vacancy?
Please answer the following questions:
Do you hold a full current manual driving licence?
Do you have the daily use of a vehicle?
Do you hold EC nationality?
If No, do you have a work permit? / What date does this permit expire?
Have you ever been convicted of any offence, including traffic convictions, or formally cautioned by the police for any offence, or bound over by the Court?
Employment with the Police Service is exempt from the provisions of the Rehabilitation of Offenders Act (1974). You are therefore required to declare all convictions even if ‘spent’ under the terms of the Act. Failure to do so may lead to disqualification or later dismissal if appointed.
If YES, please give details
QUALIFICATIONS (You may be asked to produce certificates if offered the post).
Use separate sheet if necessary.
Examination type and subject (e.g. GCSE Maths) / Date passed/due to be taken / Grade achieved/predicted (e.g. Merit, A, 2:1)
CURRENT OR PREVIOUS POLICE SERVICE
(Detail any current or previous service in any Police Force in the UK, for example, police officer, special constable, police community support officer, police support staff, volunteer or cadet)
Dates of service from – to / Force / Job Title / Reason for leaving / Line manager name
DECLARATION
I declare that the information I have provided is true and complete to the best of my knowledge and belief. I understand that if I have knowingly made a false statement or a deliberate omission in the information I have provided in this form, I may be disqualified from this application or could be dismissed.
I understand that if successful, my appointment will be subject to satisfactory evidence of medical (if applicable), fitness (if applicable), security clearance and receipt of satisfactory references.
Declaration Agreed: / Date:

IF YOU ARE A WILTSHIRE POLICE EMPLOYEE PLEASE DO NOT COMPLETE.

No approach is made for references unless a provisional offer of appointment has been made. Do you wish to be contacted before an approach is made to your current employer for a reference?
Current Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
Notice period
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
COMPLETE REFERENCE HISTORY
Name / Dates Reference Covers / Gaps
Emp Ref 1
Emp Ref 2
Emp Ref 3
Emp Ref 4
Emp Ref 5
Emp Ref 6
Emp Ref 7
Emp Ref 8
Emp Ref 9
Emp Ref 10
Edu Ref 1
Edu Ref 2
Edu Ref 3
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Previous Employer/Company Name
Job Title
Employment dates (month & year from – to)
HR email address
Manager/Supervisor’s email address
Phone number
Reason for leaving
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
EDUCATION HISTORY (only if studying in the last 5 years)
Name of School/college/university
Course studied
Date started and finished
Tutor/teacher name
School/college/university email address
School/university/college telephone number
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Name of School/college/university
Course studied
Date started and finished
Tutor/teacher name
School/college/university email address
School/university/college telephone number
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
Name of School/college/university
Course studied
Date started and finished
Tutor/teacher name
School/college/university email address
School/university/college telephone number
ADMIN ONLY
Ref Requested
Ref Received / Dates Correct
Dates Ref Covers / Revised Dates Ref Covers
EXPLANATION FOR ANY GAPS IN THE LAST 5 YEARS
I would describe my ethnic origin as:
Asian or Asian British / Black or Black British
Chinese or other / Mixed
White
Do you consider yourself to have such a disability? / Is the condition progressive?
Please indicate the category of your diability:
Physical Co-ordination / Sensory
Mobility / Manual Dexterity
Speech / Hearing
Eyesight / Memory or ability to concentrate/learn/understand
Severe disfigurement / Ability to lift, carry or move everyday objects
Other
Please describe the nature of your disability:
If you are called for interview and/or appointed to this post, do you feel that any special aids, facilities or equipment would be required to take account of your disability? Please give details:

DATA PROTECTION ACT 1998 – the information you supply on this form may be used on a computerised system.

Staff Application Form

APPLICATION FORM – SECTION B
Post Applied for:
Job Ref No: / Location:

GUIDANCE NOTES FOR COMPLETING COMPETENCY BASED APPLICATION FORMS

Prior to completing the boxes below, carefully consider the required competencies which have been selected and evidence your knowledge, skills and experience. Provide examples/evidence of when you have demonstrated each particular skill area (eg to demonstrate organisational skills you may be able to detail a function or event that you were responsible for organising or a heavy workload that you were required to prioritise and how you did this). These examples of evidence need not necessarily come from your most recent/current post.

When answering competency-based questions, provide SPECIFIC and DETAILED examples of when and how you have demonstrated each competency.

The examples you give must clearly show your approach; ‘how’ you tackled a competency and your particular involvement e.g. simply stating that you are competent in this area does not demonstrate fully what you did, how and why and therefore does not provide sufficient evidence.

·  “What was the situation?”

·  "What was your specific role, what did YOU do?"

·  “How did YOU decide which task to do first - when and why?”

·  “What was the outcome?” and "How did the outcome affect your team or organisation or company?"

·  "How has that experience affected the way you conduct yourself today – were there any learning points to take away? “

You should include as much information as possible within the confines of the box provided. If it is not included on the form, the panel will not be able to assess it.

Competency/Criteria 1
Competency/Criteria 2
Competency/Criteria 3
Competency/Criteria 4
Competency/Criteria 5
Competency/Criteria 6