Safeline

6a New Street

Warwick, CV34 4RX

Office: 01926 402498

Freephone Helpline: 0300 123 2028

E-mail:

Safeline Application Form

Please complete all sections and use additional sheet(s) if necessary

THIS SHEET WILL NOT BE SEEN BY THE PANEL

Personal:

Title / Last Name / Forename(s)
Address including postcode
Home telephone
Mobile telephone
Work telephone (if convenient)
Email address
References Please give names and full addresses in BLOCK CAPITALS of at least two persons to whom reference may be made including your present (or last previous) employer if you have recent work experience. No appointment will be made without satisfactory references.
Name:
Relationship to applicant:
Address:
Telephone No:
Email:
I give permission for this referee to be contacted:
YesNo yet / Name:
Relationship to applicant:
Address:
Telephone No:
Email:
I give permission for this referee to be contacted:

YesNot yet

Current or most recent employment

Employer / Position Held
Date commenced/Left / Current salary
Brief summary of duties and responsibilities

Employment History(please give a summary of all employment and account for any gaps in employment). Continue on separate sheet if necessary.

Period of employment / Name of employer / Position Held
And Main Duties / Reason for leaving
From / To

Voluntary or Unpaid Work History

Please tell us about any voluntary or unpaid work you are currently doing or that you have done in the past.

Period / Name of organisation and manager for whom you have volunteered / Position Held
And Main Duties / Reason for leaving
From / To

Education (secondary schools onwards)Continue on separate sheet if necessary

Schools and colleges / Duration of study / Method of study e.g. full time, part time, open learning / Subjects studied / Level / Grade/
result

Other training/qualifications relevant to the post(include apprenticeships, professional and technical studies; company training courses, evening courses, government funded courses, voluntary courses)

Name and location of employer or training establishment / Duration of training/ qualification / Subject certificates awarded
(be prepared to produce these at the interview stage if shortlisted)

Membership and level of professional associations(where applicable)

Computer Literacy(please tick the appropriate box)

Would you describe your level of IT competence (including the use of software applications and email) as:
Very competent
Competent
Basic

Driver’s Licence

Do you have a full valid UK driving licence? Yes No

Do you have access to a car for business use? Yes No

.

Declaration of Criminal Convictions. When applying for a post in Safeline, all criminal convictions must be disclosed. ‘Spent’ convictions must also be disclosed.
Have you ever been convicted of, or cautioned for, a criminal offence? Please list
Asylum and Immigration Act - If you are not a British/EU citizen please provide documentary evidence that you are eligible to work in the UK, e.g. letter from the Home Office granting leave to remain in the UK.
Nationality Passport Number
Visa Number & Expiry Date (where applicable)
National Insurance Number
Declaration I certify that the information provided is complete and correct. I understand that canvassing or failure to provide complete and correct information may result in the withdrawal of an offer of employment or dismissal if subsequently employed.
Signed: Date:

Safeline is committed to the Safeguarding of Young People and vulnerable adults and adopts strict measures to ensure the safety of its clients. Safeline expects all staff to work within its safeguarding policies and procedures.

The information contained on this form will remain confidential to Safeline.

Please return this form marked ‘private and confidential’ by email preferred or post to:

Safeline, 6a New Street, Warwick CV34 4RX

Guidance Notes for Applicants

Please read this information carefully before completing the application form.

Application packs can be received electronically by emailing:
  • All applicants are required to complete an application form. We will not accept CV’s in place of, or in addition to, the form.
  • Before you start to complete the application form it is important to read the Job Description and Person Specification.The Person Specification is very importantin the application process. An applicant must meet all the essential requirements on the Person Specification to be shortlisted for interview. The desirable criteria do not have to be met to be shortlisted, however, if you can demonstrate in the application that you also meet the desirable criteria, please do so.
  • Please fill in all sections of the application form and do not leave blank boxes.
  • Continuation sheets can be attached (in moderation) if needed.
  • Application forms will need to be photocopied so please use black pen or type. Forms will be disregarded if the handwriting is illegible.
  • Forms can be reproduced on a computer but all questions must be exactly as original.
  • Please ensure the job title is shown on the application form, as we may be dealing with more than one post.

Further Information in support of your application / Supporting Statement

  • The application should show how you meet each item on the Person Specification. Please give clear, concise examples illustrating how you meet the criteria. These can include relevant examples from outside the workplace.
  • When giving information in support of your application do not exceed 2 sides A4.

References

  • All candidates who are successful at interview will be conditionally offered a job, subject to the receipt of satisfactory references. References will only be requested for the successful candidate.
Before submitting your application
  • Check through the form to make sure you have included all relevant skills and experience. Remember: the application form is the only thing we see, we cannot guess about your skills and experience, so tell us even if it seems obvious.
  • Print off and keep a copy of your completed application form.
  • An Equality and Diversity Monitoring Form is also included in the application pack. This should be returned at the same time as your application. It will be separated from the application and not be seen by anyone involved in the recruitment panel.
  • Finally, make sure you return the form by the closing date. We are unable to consider late applications.

Reasonable adjustments for disabled applicants

  • Safeline endeavours to make reasonable adjustments (access, personal assistance, etc) to enable disabled applicants to attend for interview. If you identify yourself as a disabled person and may require reasonable adjustments to be made in the event you are shortlisted for interview, please describe what these would be on a note attached to your application form.

Registered Charity No. 1070854

Company Limited by Guarantee

Registered in England No. 03529271