ADVERT REFERENCE NUMBER:
PERSONAL DETAILS
Name:
Address:
Contact details
E-mail:
Telephone Home:
Telephone Work:
Mobile:
EMPLOYMENT HISTORY
Please give details of all jobs held including part time and unpaid work, starting with your current or most recent employer.
Name and full address of employer; nature of business. / Job title(s); key responsibilities & key achievements / Reason for leaving and date of leaving
EDUCATIONAL, TECHNICAL AND PROFESSIONAL QUALIFICATIONS
Please name any awarding institute or professional body in full and include attainment level specifying relevant grades or grade of membership.
In this section you are asked to outline how your knowledge, skills and experiences meet the competencies required for this role (as outlined in the Competency Specification).
You should draw on your experiences from your current or previous roles or from other relevant situations (such as activities outside work).
Please outline in this section why you have applied for this vacancy:
Please outline in this section how you meet the person specification set out in the job description.
(Please continue on a separate sheet if necessary, giving page number and title heading.)
Other information
Please let us know of any other information that might be relevant to your application.
References
Please give us details of two people who are prepared to act as referees. These people should not be family members and one should be your current or most recent employer. Referees will not be contacted unless you are successful at interview.
I give/do not give permission to take up my reference prior to an offer of employment being made.
(Please delete clearly as appropriate)
Have you ever been convicted of a criminal offence?YES/NO
(declaration subject to the Rehabilitation of Offenders Act 1974)
If yes, please provide details
Are there any medical conditions that you suffer from that we should know about that would prevent you from doing something essential to the job?
If yes, please can you outline the medical condition(s)?
Do you consider yourself to be disabled under the Equality Act 2010? If you have a disability please tell us about any adjustments we may need to make to assist you at interview
Right to work in the UK
Right to work
If you are selected for interview, please be prepared to bring with you, evidence of your right to work in the UK. This is required under the Immigration (Restrictions on Employment) order 2003.
For more information please visit
Please bring a passport and proof of address
OR
A Birth Certificate, Proof of NI number from HMRC and Proof of address
Data Protection
The information provided on this application may be stored and processed by Portsmouth Cultural Trust for a period of six months for recruitment purposes and if successful the information
will be stored on personal file and processed for the purpose of the employment relationship.
Portsmouth Cultural Trust keeps personal information on all employees and provides such information only on a need to know basis. By accepting a job offer, employees agree to our retainingsuch information, which can include sickness and health records, ethnic origin, trade union membership and disciplinary matters. Once a year without charge employees can inspect their records and, if necessary, request correction of any faulty records
Equal Opportunities
Portsmouth Cultural Trust is an equal opportunities employer and is committed to ensuring that our recruitment process is open, fair and not influenced by irrelevant considerations. To that end an Equal Opportunities Recruitment Monitoring Form is attached.
Declaration
All claims and/or statements of skills, experience, qualifications and employment will be checked. In the event of false claims being made, any offer of, or employment will be terminated. Portsmouth Cultural Trust reserves the right to recover from an applicant/employee any costs incurred as the result of the employment of someone who has submitted an application form (or other evidence of experience) containing false claims
To the best of my knowledge I declare that the information contained in this application form is
accurate and correct.
I understand and agree that:
a) The provision of false information may result in disqualification from the recruitment process
or termination of employment.
b) Where I cannot provide evidence of qualifications, suitable references and/or the right to
live and work in the United Kingdom the offer of employment may be rescinded and/or
employment terminated.
c) Under the Rehabilitation of Offenders Act (if it applies to the post for which I am applying)
failure to disclose any convictions spent or otherwise will result in non appointment or
disciplinary action and potential dismissal.
d) Where the post for which I am applying requires a background check, I hereby agree to the
relevant check being made by the relevant organisation about the existence and content of a
criminal records spent or otherwise.
e) The Trust does not acknowledge receipt of application forms.
Signed:
Printed name:
Date:
Once you have completed all three parts of this application form please:
- e-mail: to
If you are selected for interview, you will be required to sign this form before the interview in order to confirm that all the information provided is correct.
OR
- post : to Michelle Masterton, Portsmouth Cultural Trust, Portsmouth Guildhall, Guildhall Square, Portsmouth, PO1 2AB
THIS PAGE IS INTENTIONALLY LEFT BLANK
Equal opportunities monitoring form
This section of the application form will be detached and used solely for monitoring purposes.
Portsmouth Cultural Trust recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections of the community.
Please tick the boxes which describe you most closely:
Date of birth for monitoring purposes only