Application No

APPLICATION FORM

ROLE APPLIED FOR:

PERSONAL DETAILS

TITLE / NAME
ADDRESS
DATE OF BIRTH / POSTCODE
CONTACT NUMBERS / Daytime / Mobile
EMAIL ADDRESS
Do you have a work permit? / Yes / No / N/A
Some posts may be exempt from the Rehabilitation of Offenders Act 1974 and you are therefore required to disclose all criminal convictions, including any which may be ‘spent’. You should also include details of any cautions, reprimands or final warnings.
Do you have any criminal convictions (including those ‘spent’)? / Yes / No / N/A
Please provide details of any criminal convictions, cautions, reprimands or final warnings you have:
Do you have a clean driving license?
You will be required to provide a copy of this if your role involves driving / Yes / No
If no, please provide details

Applicants should note that any job offer is subject to a Disclosure and Barring Service (DBS) Check

Some roles will also require Police vetting

I confirm that the information provided in this application is truthful and accurate. I have omitted no facts that could affect my position within First Light and understand that any false or misleading statement could place any subsequent positions in jeopardy. I understand that my data will be held in accordance with First Light’s retention policy, and that I may be contacted regarding further relevant job vacancies within these periods:

  • All applicants not shortlisted – Application forms not retained post interview date
  • All applicants shortlist but not successful – Application forms retained for 6 months

Signature: Date:
Where did you see this opportunity advertised?
(if online please provide name of website)

RELEVANT QUALIFICATIONS / COURSES / CPD (continue on a separate sheet if required)

Level / Qualification/Course Title / Date Achieved

Copies of your certificates will be required at interview to evidence qualifications detailed above

CURRENT OR MOST RECENT EMPLOYMENT

Employer name / Job title
Employer address / Salary
Start date
Leave date/Notice period required
Reason for leaving
Main duties and responsibilities

EMPLOYMENT/VOLUNTEERING HISTORY Most recent employer first

(continue on a separate sheet if required)

Company Name & Address / Post Held and brief description of duties relevant to the post applying for / Start Date / Leaving Date / Reason for leaving

RELEVANT EXPERIENCE/PERSONAL STATEMENT

This part of your application will be used to decide if you meet the criteria and should be shortlisted for interview. Refer to the person specification and tell us how your skills and experience match. Use examples where possible and provide the situation or task, your action(s) and the result.

PROFESSIONAL MEMBERSHIP

Please detail below any professional bodies that you are a member of or affiliated to.

Professional Body / Membership Level

OTHER BUSINESS INTERESTS

Please list below all other committees, directorships, work or organisations with which you are involved or connected with.

Name of Organisation / Level of Commitment

OTHER INTERESTS

We will make reasonable adjustments to help people with disabilities through the application and selection process. If you have any specific requirements to enable your participation and/or attending during the selection process, please let us know

REFERENCES

We will be contacting referees if you are offered the position.All referees should be from either your present or past employment.

Name of Referee
Relationship to Referee
Address
Contact Number
Email address
Name of Referee
Relationship to Referee
Address
Contact Number
Email address
First Light undertakes that it will treat any personal information that you provide to us, or that we obtain from you, in accordance with our Data Protection policy which includes all data protection law.

PLEASE RETURN COMPLETED APPLICATION FORM TO:

First Light

Metropolitan House

The Millfields

Plymouth

PL1 3JB

OR

Email :

RECRUITMENT MONITORING FORM

First Light operates an Equality, Diversity & Human Rights policy and wants to ensure that all employees are recruited, trained and promoted on the basis of their ability, the requirements of the job and the need to maintain a highly effective and efficient service.

To ensure our Equality, Diversity & Human Rights policy is effective, we ask all candidates to complete the following section so we can monitor applications. The information will be treated as confidential and will be removed from the application prior to the short-listing process.

Application for:

Gender: Male Female 

Age Group:16-2526-3536-4546-55 56-65  66-70  70+ 

Do you consider yourself to have a disability?Yes  No 

Please indicate which ethnic group you belong to:

BangladeshiIndian

PakistaniBlack African

Black CaribbeanMixedBlack African

Mixed Black CaribbeanMixed Asian

ChineseVietnamese

White WhiteNon UK

Irish

Any other ethnic group (please specify)______

I do not wish to provide this information 

HR Recruitment\Recruitment Templates\Application Form

Version 9.0 04.05.2018

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