Candidate No:

Hub Dorking Volunteer Development Worker (VDW/HD814)& East Surrey Mobile Volunteer Development Worker (VDW/MOB814)
Application Form
I am applying for the following position/s: o VDW/HD814 o VDW/MOB814 o Both
Last name: / First Name:
Address: / Home Telephone:
Mobile Telephone:
E-Mail:
Employment History
Please list all work (paid and/or voluntary) that you have done, starting with most recent
Name and address of employer / Employment Period / Post held and main responsibilities
Education and Training
Secondary school/college/university including current studies and short (in work) courses
Name and address / Qualifications Gained
ReferencesPlease give details of two named referees. One must be from your present or most recent employer. Referees should not be a relative.
Name and address (current/most recent employer) / Name and address (other)
Relationship: / Relationship:
May the referees be contacted before interview? / YES/NO
Supporting Statement
Please refer to the person specification and job description and use this space to give any information you feel is relevant to your application. Continue on separate sheets if necessary.
Within the nature of the work for which you are applying this position is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, (Exemptions Order 1975). You must disclose details of any convictions in a court of law no matter when they occurred or what the nature of the offence was.
Information given is confidential and will only be considered for the purposes of this application.
If offered the post, how much notice would you have to give?
I confirm that the information given in this application is to the best of my knowledge a true and complete record. I understand that if after appointment any information is found to be inaccurate this may lead to dismissal without notice.
Signed: / Date:
Closing date for applications is 26/8/14

Please send completed application forms to Rolfe Showell, Astolat, Coniers Way, Burpham, Guildford GU4 7HL or by email to

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