Confidential
Applicants – Please complete form electronically. Please type directly into the boxes and they will expand as you type. Please rename and save the document by inserting your name before ‘Project Coordinator 2016‘
Job applied for: / Empowerment WorkerClosing date:
/21st November 2017
Interview date:
/30th November 2017
1 Personal informationSurname: / Forenames:
Known as:
Permanent Address:
Contact details:
Home: / Work:
Mobile: / E-mail address:
2 References
Two referees are required. One of these should be your present or most recent employer. These will not be contacted until after the interview.
Present/most recent employer
/Second referee
Name: / Name:Address: / Address:
E-mail address: / E-mail address:
Telephone number: / Telephone number:
Capacity in which known to you: / Capacity in which known to you:
3 Education
Please give here relevant details of education and qualifications including current/proposed courses.
Schools/Colleges/Universities
/Qualification(s) / dates
4 Other trainingPlease give details of other training undertaken and any membership of professional associations.
5 Employment5.1 Present or most recent post (paid or unpaid)
Job Title: / Salary:
Name and address of present or most recent employer:
Reporting to:
Reason for leaving:
Please give a brief description of duties and responsibilities:
5.2 Previous Posts
Please list all previous employment, starting with the post held immediately before the post described above:
Job title and name and address of employer and dates: /
Brief description of main responsibilities:
Supporting Information:
Please give further information in support of your application
With reference to the person specification, use this section to tell us how your experience, main achievements, skills and knowledge make you a suitable candidate for this post. Please address each point on the person specification. You may draw on all aspects of your experience and education and include paid and unpaid employment.
Use no more than 3,000 words (excluding headings from the person specification) for this section.
9 Additional informationAre you able to attend an interview on the 30th November, 2017?
Do you need a work permit to work in the UK? / Yes/No
If yes please specify:
If appointed when could you start?
Do you have any unspent convictions within the terms of the Rehabilitation of Offenders Act? / Yes/No
Health
Please provide any information we need to know at this stage in your application e.g. if invited to interview would you need any particular arrangements i.e. communicator, equipment?
10 Declaration:
I declare that the information provided on this form, and on any accompanying documents, is true to the best of my knowledge and belief. I understand that false information may lead to the termination of employment or withdrawal of a job offer.
I agree that the content of this form and of any accompanying documents may be treated as part of any Contract of Employment agreed between myself and OSARCC.
Signed:...... ………………...……………
Date:...... ….....…………………
Please email the completed forms to:
Equal Opportunities Monitoring Form
/Confidential
This information will be treated as confidential, and used solely for monitoring purposes. The form will be separated from the application form before short-listing of candidates takes place. The form will not be considered as part of the selection process.If you prefer not to disclose any of this information, please leave the section(s) blank
Post applied for:How did you find out about this vacancy? (Please tick one box only)
Daily Info / Charity JobsLocal Press / OSARCC Website
Other (please describe)
I would describe my ethnic origin as (please tick one box only)
Please tick this box if you would prefer not to answer this question:
White / Asian or Asian British
British / Indian
Irish / Pakistani
Any other white background / Bangladeshi
(please describe) / Any other Asian background
Mixed / (please describe)
White & Black Caribbean / Black or Black British
White & Black African / Caribbean
White & Asian / African
Any other mixed background / Any other Black background
(please describe) / (please describe)
Chinese or other ethnic group
Chinese
Any other background (please describe)
Please describe your religious group
Please tick this box if you would prefer not to answer this question:
How would you describe your sexual orientation?
Please tick this box if you would prefer not to answer this question:
Heterosexual / Lesbian
Gay / Bisexual
Other (please describe)
Please indicate your age
Age / Date of Birth
Disability
Do you have a disability as defined by the Disability Discrimination Act 1995?
YesNo
If ‘yes’, please give brief details of the effects of your disability on your day-to-day activities, and any other information that you feel would help us to accommodate your needs and thus meet our obligations under the Disability Discrimination Act 1995. A disability in no way precludes you from consideration for a position and OSARCC wishes to assist and support applicants with a disability through the recruitment process. Please continue overleaf as required…