CONFIDENTIALAPPLICATIONFORM

Pleasereturnyourapplicationformandequalopportunitiesmonitoringformby post or by emailto: or to Naomi Goldberg, Chief Executive, GAVS, The Forum @ Greenwich, Trafalgar Road SE10 9EQ by 5pm on 21st December 2012.

Pleasecompleteallquestionsasfullyaspossible.Wecanonlyshortlistyouontheinformation you provideon the form. CVs will notbe considered.Pleasewrite clearly in black ink.

WewishtoensurethatcomparisonbetweenapplicantsisfairandinlinewithGAVSEqual

Opportunities policies.

POSITION APPLIED FOR:……………Development Assistant

Personaldetails

Surname / First Name(s)
Address
Email
Contact No: / Mobile Tel No:
Full Driving
Licence: / YES/NO / Endorsements: / *YES
/NO
* If YES, pleasegivefurther details including
dates.

References

Pleasegivedetails of tworefereeswhowill be happy tobe contacted prior to interview.One shouldbe from your present or mostrecent employer. These shouldnot includerelatives or purely personal friends.

FirstReferee / Second Referee
Name: / Name:
Positionheld:Positionheld: / Positionheld:
Address: / Address:
Telephone No. / Telephone No.
Email: / Email:

Employment history

Paid and/orvoluntary

Pleasecontinue ontoseparatesheets if necessary

Dates
From/to / Name and Address of
organisation / Role and Key Responsibilities

Pleasecontinue on separatesheets if required

Education

Pleaselist any education you haveundertaken:

Establishment
Name &Address / Dates / Course / Qualifications

Professionalqualifications/othertraining

Pleaselist all relevant training coursesattended

Date / Course title / Accreditation body

Pleasecontinue on separatesheets if required

Supporting information

Pleaseletusknowwhyyouare applyingforthispostgivingdetailsofanyrelevantskillsand experience whichyou mightbring totheposition. Pleasereadthepersonspecificationandjob descriptionbeforeyouanswerthis sectionas theyoutline theskills,knowledgeandexperience required forthispost.

Pleasebe concise in your answers. Pleaseuse additional sheets if required.

Disclosures

Are you involvedin any activity whichmight limit your availability towork or your
working hours e.g. localgovernment? / YES/NO
If YES, pleasegivefull
details.
Are you subject toany restrictions orcovenants which might restrict yourworking
activities? / YES/NO
If YES, pleasegivefull
details
Are you willing towork overtime andweekends ifrequired? / YES/NO
Pleasegivedetails of any hourswhich you wouldnot wish
towork:
Haveyou any convictions (other than spent convictions under the Rehabilitation of
OffendersAct 1974)? / YES/NO
If YES, pleasegivefull
details
Doyou need a work permit totake up employment in the U.K.? / YES/NO
How muchnotice areyou required togivetoyour current
employer?

Declaration

Ideclare theinformation given on this form is correct tothe best of my knowledge. Signature: …………...... ………… Date: ………………….

Data Protection Act 1998:

The personal information submitted by you on this application form andin any accompanying documents will be usedby GAVS. The information will be kept for 2years.For successful applicants, information will be taken from thisform and usedas part ofyour personnel record.

Igiveconsent for the information given on thisform tobe used by GAVS for recruitment, payroll and Equal Opportunitiesmonitoring.

Signature: ……………...... ………Date:……………………….