Naz Project London
Sexual health and HIV services for Black, Asian and Minority Ethnic communities in London.
JOB APPLICATION FORM
Please complete and return this form to:Please let us know if you require this form in another format
You may post this form if you prefer using the following address:
Job Application
Naz Project London
30 Blacks Road
LondonW6 9DT
Post Applied For:
- Personal Detail
Salutation:
(eg Mr/Mrs/Ms)
/ Last Name / First Name(s)Permanent Address:
Post Code: ______/ Telephone No.
Home: ______
Work: ______
Mobile: ______
Email: ______
- Education/Training & Qualifications
Please include all education, including professional qualifications. You may include any other any training feel is relevant for this role, either directly or indirectly.
Please list the most recent first.
Name of institution (school, college, university, training provider, etc) /Start and end date
/ Qualifications and level attained(where relevant)
Professional memberships: Please list any relevant organisations to which you belong, including level of membership
Volunteer experience:
Organisation, position held and main tasks / Start and end date
- Most recent appointment
Name & Address of most recent employer
______
______
______
Job Title / Salary / Start date:
Finish date:
Please give a brief description of your main duties and responsibilities, including your reasons for looking for another job:
4. Previous Employment (most recent first, you may expand this section if required)
Name and address of employer / Start and finish date / Job title, Number of days per week, Main Duties and Reason for leavingPlease address any gaps in your employment and education history. You may expand this box or attach additional sheets if required.
- Additional Information
Language skills – Please indicate degree of fluency
Spoken: / Written:
With reference to the Person Specification for this job, tell us what skills/experience you will bring and why you believe you are a strong candidate for this job. Please expand or attach extra pages if necessary. We recommend you address each point on the person specification in a separate paragraph or paragraphs.
What are your main interests and hobbies? You may expand this section.
Under the Immigration, Asylum and Asylum and Nationality Act 20066, we have a legal obligation to ensure that all staff have the right to work in the UK, and will carry out a right to work document check before any offer of employment is confirmed.
Do you have permission to work in the UK? YES _____ NO_____
Are there any restrictions to your residence in the UK which might affect your right to take up employment in the UK? YES _____ NO_____
If yes, please give details:
Period of notice required by your present employer:
Rehabilitation of Offenders
The nature of work involved in the position for which you are applying will bring you into contact with vulnerable people and information about vulnerable people. Therefore it is exempt from the Rehabilitation of Offenders Act by virtue of the Rehabilitation of Offenders Act (Exemptions Orders) 1975.
You must declare details of any cautions, criminal convictions, reprimands or final warnings given by the police and any proceeding being instituted against you.
Having a criminal record will not necessarily bar you form working with us, this will depend on the nature of the position and the circumstances of the offence(s).
Please make your declaration below, this information will only be seen by those who need to see it as part of the recruitment process.
Do you have any cautions, criminal convictions, reprimands or final warnings given by the police, or any proceedings instituted against you? YES ____ NO ____
If ‘Yes’, please give full details on a separate sheet and send with the application.
Please give the names and addresses of two persons, who should not be relatives or friends, from whom references may be obtained. One should be your present employer, or previous employer if currently unemployed.
1. Name ______2. Name______
Address______Address______
______
______
Tel. No. ______Tel. No. ______
Email: ______Email:______
Relationship to you: ______Relationship to you: ______
Do we have permission to approach these referees immediately? YES_____ NO_____
Where did you see the advertisement for this appointment?
Declaration: I declare that the information I have given in this application is accurate and true. I understand that providing misleading or false information will disqualify me from appointment or, if appointed, may result in my dismissal.
Signature ______Date ______
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