Application for Employment

Position Applied For: / Application No:

CRMC is an Equal Opportunities employer and your application for employment will be assessed solely on its merits. We welcome applications from all sectors of the community, irrespective of age, gender, ethnic origin, disability, religious or philosophical belief or sexual orientation.

Personal Information

Surname / Family Name / Forename(s)
Address
Postcode
Home Tel No. / Mobile No.
Driving Licence Type / Driving Licence No.
NI No:
Do you have the right to work in the UK? / Yes / No

Details of Academic and Professional Qualifications held

(You will be required to produce the certificates as evidence)

Place of study / Qualification(s) gained / Grade & Date Awarded

Membership of Professional Bodies

Professional Body / Grade of Membership / By Examination
Yes/No / Dates of Examination

Training Undertaken

Training Organisation / Course Title / Duration / Date Undertaken

Rehabilitation of Offenders Act 1974

Please provide full details of any convictions not excluded by the Rehabilitation of Offenders Act 1974.

Details of Conviction / Date of Conviction / Sentence

References

Please provide details of two professional referees, one of whom must be you last, or latest, employer. Please note that character references will not be accepted. References will only be taken if you are offered (and you accept) the role. We will not contact your referees under any other circumstances.

Name
Position
Address
Post Code
Telephone No.
Time known
Capacity in which known

Present/Most Recent Employer

Employer Name
Address
Postcode
Telephone No. / Fax No.
Date started / Date ended
Job Title / Notice required
Dates / Job Title / Key duties/Responsibilities
From / To


Employment History

Please list previous employers (including details of any temporary employment held, most recent first, and account for any gaps in your employment. Continue on a separate sheet if necessary.

Employer Name & Address / Dates / Job Title & Key Duties/Responsibilities
From / To

Examples of competence for the role

This is an opportunity for you to demonstrate your competence for the role advertised. Please fill in the section below, comprehensively detailing real life examples which demonstrate that you have the skills and experience required to carry out the tasks in the job description. You may continue on separate sheets if required.

Declaration

CRMC stores and processes data in accordance with the Data Protection Act 1998. I understand that the details I have provided on this form and other associated documents will be stored and processed in accordance with CRMC’s recruitment procedures. In completing this form I give my consent for the details to be to be used for this purpose.

I declare that all forgoing details given in this application are true to the best of my knowledge. I understand that if I have knowingly provided false or withheld material information I may be dismissed from any post gained as a result.

Signature / Date

Please send completed application form to or by post to: CRMC, 15 Bishop Street, Coventry, CV1 1HU. Please make sure you clearly indicate the application/project ID (Accelerate/0716) in the subject line.

CRMC - Application for employment Page 5 of 5