KALAYAAN

justice for migrant domestic workers

Post applied for: / Date:
Where did you see the post advertised?
Family Name: / First Name:
Address:
Postcode: / Telephone No.
Day:
Evening:
Email:
Please give contact details of three people to whom we may apply for references. Two of your referees should be your most recent employer and a past employer, and the third, someone who knows you well.

REFERENCE 1

Name:
Address:
Telephone No:
Day:
Evening: /

REFERENCE 2

Name:
Address:
Telephone No:
Day:
Evening: /

REFERENCE 3

Name:
Address:
Telephone No:
Day:
Evening:
Capacity in which you know this person? / Capacity in which you know this person? / Capacity in which you know this person?
NB. References will only be taken up if you are offered this post.
When would you be free to take up a new appointment?
Please confirm that you have the right to work in the UK YES/NO
Post applied for: / Name:
(initial and family name only)
EDUCATION
Secondary School / From / To / Qualifications obtained
College/University/
Professional / From / To / Qualifications obtained
TRAINING/RELEVANT EXPERIENCE - Please list details of relevant training courses attended
Details (name of course; length of course; training body; qualification etc.) / From / To
Post applied for: / Name:
(initial and family name only)

EMPLOYMENT HISTORY

Present/most recent employer / Title of Post: / Date appointed:
Sector: Commercial 
Voluntary 
Government & Public  / Salary: / Leaving date:
Summary of duties (relevant to this post) and reason for leaving:
PAST EMPLOYMENT - Indicate any jobs you have had on a paid or voluntary basis (most recent first)
If there is any long gap in your employment history please explain

Employer

/ Job Title / From To / Duties:
Post applied for: / Name:
(initial and last name only)
HOW YOU MEET THE POSITION’S REQUIREMENTS
Please explain how you meet the criteria for this post, as listed in the person specification. Address each of the essential requirements and any desirable requirements you fulfil.
Please use additional sheets if necessary (but please do not submit more than 2 A4 sheets in total).
Please do NOT attach a CV as we do NOT shortlist from CVs.
Short-listing will be based on the evidence you provide of your ability to meet all aspects of the candidate specification.
Post applied for: / Name:
(initial and last name only)
Further information
Please add any additional comment that you feel might support your application (such as reason of your interest in the post, etc) in the space provided. Pleasedo not exceed this A4 page.
Post applied for: / Name:
(initial and last name only)

REHABILITATION OF OFFENDERS ACT 1974

This act requires job applicants to give details of any unspent criminal offences. If you disclose a conviction, you will not necessarily be barred from employment.
Have you any unspent criminal convictions or cautions? Yes No
If you answered ‘yes’, please give brief details of the nature of the offence, place and date of judgement and sentence.
HEALTH
A disability or health problem does not preclude full consideration for the job and applications from disabled people are welcome. However, unfortunately, our building does not have a lift or wheelchair access. All information will be confidential.
Are you registered disabled? Yes No
If ‘yes’, please give details.
Please give details of sickness or other absences over the last two years.

DECLARATION

I can confirm that to the best of my knowledge I have no medical condition that will prevent me carrying out the job as described to the full. I also confirm that the information given on this application form is correct to the best of my knowledge and I consent to Kalayaan checking any information provided. I confirm that I have permission to work in the UK. I understand that Kalayaan may terminate my employment without notice if I make a false or misleading statement.
SIGNED: DATE:

All posts at Kalayaan require an understanding of the needs of migrants and issues facing ethnic minorities in the UK. In addition, we require a strong, personal commitment to equal opportunities from all our employees.

Please email completed forms to:

(please specify ‘CA application’ in the subject)

Alternatively, you can post or fax your application to:

Rita Gava

Director

Kalayaan

St Francis Centre

13 Hippodrome Place

London W11 4SF

Fax: 020 7792 3060

Applications to reach Kalayaan by 9.30 am on Monday 15th June 15

Interview date:23rd June 15

1

APPLICATION NUMBER (Administration only):