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PENARTH TOWN COUNCIL

CYNGOR TREF PENARTH

EMPLOYMENT APPLICATIONFORM

The information requested in this form is important in assessing your application and should be completed in full. A CV on its own will not be accepted as an application but can be included as a supplement to the application form.

POST TITLE : Policy, Innovation & Development Officer

Grade S01 - £25,951 – 27,668 pa

PERSONAL DETAILS

Name:
Address:
Post Code:
Telephone No.
Email:
National Insurance No

EMPLOYMENT HISTORY

MOST RECENT EMPLOYMENT

Present / Most recent employer
Job Title:
Salary / Wage:
Additional Benefits:
Period of Notice Required:
Reason for wanting to Leave:
Do you supervise other employees?
If so, how many?
Brief Description of Duties and Responsibilities (Please attach a copy of your present job description, if available)

PREVIOUS EMPLOYMENT(Last three appointments, most recent first)

Employer / From / To / Post / Salary/Wage

EXPERIENCE AND ACHIEVEMENTS

(Please use this space to state your reasons for applying for the post and explaining how you would relate your education, training and experience as well as personal qualities, including unpaid work and interests to the post for which you are applying. You should relate your comments to the job description, person specification and further particulars for the post)

Continue on a separate sheet if necessary

OTHER SKILLS AND ABILITIES

(e.g. computer, languages etc.)

EDUCATION AND TRAINING

School/College/Other / Qualification &Year / Grade
Other courses / Result / Year

c.Membership of Professional Bodies

Body / Grade of Membership / Whether by exam / Date

ADDITIONAL INFORMATION

Are you related to any Member or employee of Penarth Town Council? Yes/No If yes, please state name and relationship:

Have you been convicted of a criminal offence? Yes/No If yes, please give details except spent convictions under the Rehabilitation of Offenders Act 1974

Do you hold a current full clean driving licence? Yes/No

Do you have use of a car/motorcycle? Yes/No

Please give details of any current endorsements

Please give details of absence due to sickness (not disability) over the last two years

Where did you see this job advertised?

REFERENCES

Please give the names of two persons to whom reference may be made in respect of your application as to your abilities and experience. The first should be from your present or past employer.

Referees are only contacted if candidates are to be interviewed.

Name: / Position
Address
Tel: No

If you do not wish this referee to be contacted without further reference to you or until a provisional offer of employment is made, please indicate by ticking the box □

Name: / Position
Address
Tel: No

If you do not wish this referee to be contacted without further reference to you or until a provisional offer of employment is made, please indicate by ticking the box □

NOTE

Canvassingof members of the Council or any Committee of the Council, directly or indirectly, for any appointment under the Council shall disqualify the candidate concerned for that appointment. However, a Member is not precluded from giving written testimonial of a candidate’s ability, experience or character.

DECLARATION

DATA PROTECTION: All or part of the information provided on this form may be stored on computer files and used for personnel administration. Such use will be subject to the provisions of the Data Protection Act 1998. If you are appointed, this information will be retained during the period of your employment with the Town Council. If you are not appointed, your information will be kept for a period of 4 months following the decision on appointment, following which it will be destroyed.

DECLARATION

I confirm that the information given in this application is true and complete to the best of my knowledge. I understand that the information given will constitute the basis of any contract of employment that may ensue and that any false statement or wilful omission may be sufficient cause for my application to be rejected or employment by the Council revoked.

Signed:Date:

PLEASE RETURN THIS APPLICATION TO THESENIOR FINANCE & HR OFFICER, PENARTH TOWN COUNCIL, WEST HOUSE, STANWELL ROAD, PENARTH, CF64 2YG,

Email: