LANCASHIRE POLICE AND CRIME COMMISSIONER
APPLICATION FORM
Lancashire Police and Crime Commissioner operatesan Equal Opportunities Policy and welcomes applications from all sections of the community.
Please complete the application form in full, continuing on separate sheets if necessary. Return your application via email to adding Application and the relevant job title to the subject box. Applications received after the deadline will not be considered. Any queries please contact: 01772 533587
IN CONFIDENCE
Position applied for:Please state where you say the post advertised:
1 PERSONAL DETAILS
Surname: (block letters)
Forenames: (in full)
Title: (Dr Mr Mrs Miss Ms etc)
Address:
Postcode:
Tel No: (Home) / (Work)
Tel No. (Mobile) / Date of Birth:
I confirm the accuracy of this application form.
Signed: / Date:
2 EDUCATION (Please insert full details of secondary schools and colleges/universities attended)
Schools/Colleges/
Universities / Qualifications Obtained / Date Obtained
Membership of Professional Bodies
Name and Address of present employer:
Present post:
Date appointed: / Salary: / £
National Insurance Number:
3 Previous Employment
Employer / Dates / Position Held
From / To
Details of any other specialised training or qualifications not covered in previous sections (eg short courses, on the job training, etc.)
4 Experience and Achievements
Please provide a concise account of relevant experience and achievements in support of this application. Please ensure you address each of the essentialand desirable requirements as listed in the order described in the Person Specification. Please use a maximum of 150 words for each requirement.
5 / Do you have any criminal convictions? / Yes / [] / No / []
(Your attention is drawn to the fact that under the Rehabilitation of Offenders Act, 1974, you may be entitled to answer 'no' to this question even if you have, in the past, been subjected to criminal proceedings resulting in conviction(s)).
If yes, please give details
6 / Do you consider yourself to have a disability? / Yes / [] / No / []
(Please tick as appropriate)
7 / Do you hold a current driving licence? / Yes / [] / No / []
(Please tick as appropriate)
8 / Are you able to attend evening meetings? / Yes / [] / No / []
(Please tick as appropriate)
9 / Period of notice required to terminate current employment
10 / Names, addresses and occupation/relationship of two referees: (one of whom should be your current employer or, if unemployed, your last employer)
Name: / Name:
Address: / Address:
Tel No: / Tel No:
/ Please do not contact prior to interview / / Please do not contact prior to interview
(NB Please indicate if you do not wish your current employer to be contacted prior to the interview)
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