APPLICATION FORM

Please complete all sectionsof this form in black ink or type as it will be photocopied. Do not send a CV, as this will not be used as part of the selection process. Applicants needing help completing the application form are advised to contact Amanda Channer at the address below.

Completed applications should be sent to Amanda Channer, Resources and Building Services Manager, Astolat, Coniers Way, Burpham, Guildford, Surrey, GU4 7HL or toemail . Envelopes or email subject lines should be marked with the name of the post(s) for which you are applying.

Application For The Post Of:
How Did You Hear About This Role?

Personal Details

Surname / Forename(s)
Address
Postcode
email
Home phone / Mobile phone
Preferred daytime number

Education and Training

Education (from age 16)

(Box will expand automatically as you type)

School / Subject & Level

Further Education, Higher Education and Professional Qualifications

(Box will expand automatically as you type)

Institution / Qualifications Gained

Relevant Training

(Box will expand automatically as you type)

Course / Length of Course

Employment History

Present Employment/Voluntary Work (or last employment if not currently employed)

Employer Name
Employer Address
Position Held
Date from / Date to / Final salary
Brief outline of duties and responsibilities
Notice period (if current position)
Reason for leaving

Previous employment (including part-time or holiday jobs lasting more than six weeks) in reverse chronological order (most recent job first)

(Box will expand automatically as you type)

Dates From/To / Name and address of employer / Position held / Key responsibilities / Reason for leaving

Skills and Experience

Other relevant experience, however gained.

(Box will expand as you type)

Hobbies and interests - including membership of clubs and societies.

(Box will expand as you type)

With reference to the job description, and using examples wherever possible, highlight what skills and experience you will bring to the post.
(Box will expand as you type)

Other information, References and Declaration

The role will involve some travel within Surrey. While public transport is preferred it is not always practical. Please confirm that you have access to suitable transportation for travel within Surrey while discharging your duties. / Yes
No

Please give details of two people who can provide us with an assessment of your suitability for this post. If you are currently employed, one of your referees should be your employer. If you are unemployed, one of your referees should be your most recent employer. Personal referees are not advised. Please contact us if you are unsure about who to put as your referees.

Referee Name
Organisation
Role
Address
Telephone
email
Relationship to applicant (eg line manager, tutor etc)
Can we contact this referee before interview?
Should we inform you before taking up reference?

We are required by law (Asylum and Immigration Act 1996) to ensure that anyone working for us is entitled to live and work in this country. Accordingly, if selected for interview we will require to see evidence of your right to work in the UK.

"I hereby declare to the best of my knowledge that the information given on this form and attached papers is true and correct and can be treated as part of any subsequent Contract of Employment."

Signed / Date

To help us ensure that we advertise our posts in the most effective places, please tell us where you saw this post advertised:

Do not forget to read and complete the next, and final, page.

The information on this page will not be used as part of the selection process

Equality Act 2010

If you are a disabled person and you fulfil the criteria for the post, you will be given an interview. Please give details of any disabilitiesyou have and let us know of any special requirements you have to enable you to attend an interview. We are an Equal Opportunities Employer at Surrey Community Action and feel it is important that there is no disadvantage to any applicant as a result of disability.

Disclosure of Criminal Convictions

Under the Rehabilitation Act 1974, ex-offenders do not have to disclose their criminal convictions when applying for most (but not all) jobs if their convictions have become spent. Jobs where criminal convictions have to be disclosed are called “exempted posts”, and for these posts convictions are never spent and must be disclosed. It takes between 6 months and 10 years for a conviction to become spent (see the table below). Custodial sentences of more than 2 ½ years can never become “spent”. Few posts within Surrey Community Action are exempted, and the job description will state clearly if this post is exempted.

An unspent conviction will not automatically preclude you from employment at Surrey Community Action.

Sentence / Rehabilitation Period
18 or over on conviction / Under 18 on conviction
Detention in prison, youth custody or young offenders’ institution for a sentence between 6 and 30 months. / 10 years / 5 years
Detention in prison, youth custody or young offenders’ institution for a sentence not longer than 6 months / 7 years / 3½ years
For a sentence of Borstal training (abolished 1983) / 7 years / 7 years
For a fine or other sentence (e.g. community service order) where no rehabilitation period is prescribed / 5 years / 2½ years
For an absolute discharge / 6 months / 6 months
For detention by direction of the Home Secretary (abolished 1988) / 3 years / 3 years
Probation (those convicted before 3 February 1995); conditional discharge / 1 year or until the order expires (whichever is longer)
Do you have any unspent criminal convictions, cautions? / Yes
No

If yes, please enclose details in a separate letter along with your application form. Place your letter in a sealed envelope marked "FAO CEO - private and confidential". If applying electronically, include a separate document file with the same line as its filename. Any information provided will be treated in strict confidence and will not be used to influence the short-listing process.

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