EQUAL OPPORTUNITIES & DIVERSITY MONITORING

Position applied for ______Number ______

Where did you see this position advertised?

Havebury is an Equal Opportunities employer. Our policy is to ensure that no job application or employee receives less favourable treatment or is disadvantaged by any conditions or requirements that cannot be shown to be justifiable. To assist us in checking that this policy is carried out, and for that purpose only, it would help if you could complete the following. You are under no obligation to complete this section and it will not affect your application in any way. This section will be removed from the application form and is for monitoring purposes only by the Human Resources Department.

1.

White British / White Other
White Irish
Mixed White & Black Caribbean / Mixed White & Asian
Mixed White & Black African / Mixed Other
Asian or Asian British Indian / Asian or Asian British Pakistani
Asian or Asian British Bangladeshi / Asian or Asian British Other
Black or Black British Caribbean / Black or Black British African
Black or Black British Other
Chinese – Chinese / Other
Chinese/Other ethnic background / Do not wish to answer

2.

Male / Female

3. Date of Birth ______

4.

Heterosexual / Gay
Lesbian / Transsexual
Bisexual / Prefer not to answer

5. A disability will not preclude full consideration for the job and applications from suitable people with disabilities are welcome. All information provided by the applicants will be treated as confidential.

How would you describe your health

Able Bodied with no medical condition / Able bodied with a medical condition
Disabled requiring no special facilities / Disabled needing special requirements or assistance with facilities or resources
Do not wish to answer
If you are disabled, please give details of any special arrangements you would require to attend interview

6.

Have you any unspent criminal convictions which may be considered as relevant to the position for which you are applying? / Yes
No

For some positions it will be a requirement for successful applicants to complete a Criminal Records Bureau check. In these cases any offer of employment will be subject to an acceptable outcome.If so, please attach details. Rehabilitation of Offenders Act 1974 applies. A declaration of an offence will not necessarily preclude your application being shortlisted.

APPLICATION FORM

All information supplied on this application form will be treated as STRICTLY CONFIDENTIAL

Post applied for
Location
Surname / Title
First Name / Known as:
Previous Names (if any)
Address
Postcode
Telephone Home /
Please indicate if we can contact you on the numbers above
Work
Mobile
Email address
National Insurance No
Are you eligible to work in the UK?
Do you hold a full, current Driving Licence valid in the UK? / This information is only relevant for some posts
Do you have any penalty points?
Do you have access to a vehicle?

EDUCATION DETAILS

Secondary Education

Dates
From - To / Name & Location of School / Subjects / GCSE/
A-Level/Other / Grade

Further Education

Dates
From - To / Name & Location of School
Polytechnic/University / Subjects studied / Qualifications gained / Grade

PROFESSIONAL DETAILS

Professional Qualifications

Professional Qualifications Obtained / Date of Examination

Membership of Professional Bodies

Name of Professional Body / Level/Type of Membership / Reg. Number / Renewal Date

Current Relevant Training and/or Study

Brief Description / Anticipated Completion Date

EMPLOYMENT DETAILS

Please start with your most recent experience and account for any breaks in employment. You may continue on a separate sheet if necessary.

From / To / Organisation Name & Address / Job Title / Brief description of duties
Salary / Reason for Leaving
Notice Period from Current Job
From / To / Organisation Name & Address / Job Title / Brief description of duties
Salary / Reason for leaving
From / To / Organisation Name & Address / Job Title / Brief description of duties
Salary / Reason for leaving
From / To / Organisation Name & Address / Job Title & Salary / Brief description of duties & Reason for leaving
Salary / Reason for Leaving
From / To / Organisation Name & Address / Job Title / Brief description of duties
Salary / Reason for Leaving

REFERENCES

Please give names and addresses of two employment references to whom we may apply for a reference. These referees must be able to comment on your ability to meet the demands of the job for which you are applying. Your first referee should be/have been your line manager or a member of the Human Resources Department.

Reference 1 (current or last employer) / Reference 2
Name of Referee / Name of Referee
Job Title of Referee / Job Title of Referee
Organisation’s Address / Organisation’s Address
Postcode / Postcode
Phone No / Phone No
May we contact this person? Y or N / May we contact this person? Y or N

FURTHER INFORMATION

Please use this section to explain why you are applying for the post and how you meet the person specification (including what relevant experience, training and skills make you suitable for the position).

DECLARATION

Are you related to or do you have a close relationship with any employee or committee member of the Partnership? If so, please give brief details:

Are you a current or former tenant of The Havebury Housing Partnership? Please give details

I declare that the information I have given on this form is, to the best of my knowledge, true and complete. I understand that if it is subsequently discovered that any statement is false or misleading, or that I have withheld relevant information, my application may be disqualified or, if I have already been appointed, I may be dismissed. I hereby give my consent to Havebury to process the data supplied on this application form only for the purpose of recruitment and selection.

Havebury complies with the Data Protection Act and processes personal sensitive data in accordance with the Data Protection Act 1998

Signed

Date