VOLUNTARY SERVICE ASSOCIATION LTD.

APPLICATION FOR APPOINTMENT AS –Access Lewisham Project Coordinator

(PLEASE COMPLETE IN BLACK INK)

Closing date/time: Friday 9th February 2018 4pm

Interview dates:Thursday 15th & 16th February 2018

1. Personal Details
Surname: Forenames: Title:
Address:
Post code:
Tel No: / Mobile No:
May we contact you at work? Yes/No (we will do so discreetly)
Work Tel No:
Email address:
2. Previous Staff and Volunteers
Have you previously been employed by Voluntary Service Association? Yes/No
Are you currently a volunteer with Voluntary Service Association? Yes/No
Are you, to the best of your knowledge, related to any member of staff or
member of the Board of Trustees of Voluntary Service Association? Yes/No
If Yes to any question, please give details and dates if applicable :

Voluntary Service Association Ltd Lewisham Community Hub, Ground Floor, Leemore Centre, 29-39 Clarendon Rise, SE13 5ES.

T: 020 8291 1747 E: W: Registered Charity no: 266585 Registered in England no: 1131214

3.Current Or Most Recent Employer
Full-Time/Part-Time (delete as appropriate) Present salary:
Name of Employer / Job Title / Salary / Dates with employer / Reason for Leaving
Brief Description of current duties and responsibilities:
Current notice periodrequirement:
4. Previous Employment
Last Ten Years – please account for any gaps in employment.
Continue on separate sheet if necessary
Dates / Employer / Salary / Job title and brief outline of main duties / Reason for leaving
5. Education and Training
Dates Attended / school/college/university
or professional assoc. / Qualification and Grade
6. Other Relevant Training Courses and/or Volunteering Experience
Dates / Organising body / Brief description of course content/ volunteer role
  1. Supporting Statement

Please ensure you give actual examples from your previous work experience or other activities to demonstrate your ability to meet the requirements of the job description and how you would fulfil each point on the person specification
Please note that CV’s are not acceptable as an alternative to completing this section

Continue on a separate sheet if necessary

Outstanding Disciplinary Proceedings
Are you subject to any outstanding disciplinary action? Yes/No
If yes please give details in a separate envelope marked private for the attention of the Chief Executive Officer
Other Information
A full UK driving licence is required for this role
Do you have any current penalty points Yes/No
If yes, how many?
Disability Discrimination Act 1995
The Disability Discrimination Act 1995 defines disability as:
A physical or mental impairment which has a substantial and long term adverse effect
on your ability to carry out normal day-to-day activities.
Do you have a disability which requires the provision of specific facilities or support at interview (e.g. wheelchair access, sign language)? Yes/No
If so, is there anything we could do to assist you? (please give details).
  1. References

Please give the names and addresses of two referees, one of whom should be your present or last employer. Please indicate if you do not want referees to be contacted unless you are offered the post.
Please not that relatives and friends are not acceptable referees regardless of their occupation or professional qualification.
Name: / Address: / Tel No:
1. / Business:
Home:
In what capacity is the person above known to you?
2. / Business:
Home:
In what capacity is the person above known to you?
  1. Criminal Convictions

The post for which you are applying involves working with vulnerable people, therefore a criminal records check through the Disclosure and Barring Services (DBS) will be carried out on the successful candidate.
Please also answer the following questions, if yes, please give details in a separate envelope marked Private for the attention of the Chief Executive Officer:
Have you ever been cautioned or convicted of any civil and/or criminal offence?
Yes/No
Are there any allegations or convictions, cautions, reprimands or final warning which would not be filtered in line with current guidelines?
Yes/No
Failure to notify us of any such convictions, cautions or warnings at this stage could result in any agreement between us being terminated.
  1. Asylum and Immigration Act 1996 - Proof of legal right to work in the UK

Are you required to have a UK work visa/permit? Yes/No
If so, do you have a valid visa/permit? Yes/No
11. Declaration
Please sign the declaration below to confirm that the information you have provided is correct. Any offer of employment by the Voluntary Service Association is subject to the receipt of two satisfactory references and a satisfactory DBS check.
In accordance with the Data Protection Act 1998, it is agreed that Voluntary Services
Lewisham may hold and use personal information about me for personal reasons and to enable Voluntary Service Association to keep in touch with me. This information may be stored in a computer database or/and manual files.
If I am not appointed all manual and data files will be deleted in accordance with the Data Protection Act 1998.
I understand that that it is a criminal offence to attempt to obtain employment by deception and that any misrepresentation, omission of material fact or deception will cause immediate cancellation of consideration for employment, or dismissal if already employed.
I certify that the information provided in this application (and any additional information enclosed) iscorrect.
Signed:……………………………………. Date: ___/___/___