Please complete this form and email it to by the deadline advertised.
If you need to print and post your application, please ensure you allow time for delivery.
DO NOT submit a CV as it will not be accepted.
Post applied for
Job reference number
Closing date
1. PERSONAL DETAILS
Name / First: / Surname:
Home Address
Postcode:
Contact Telephone / Home: / Mobile:
Email
2. EDUCATION AND QUALIFICATIONS
Start with most recent and include any current studies
Name
Type of establishment / Period / Full and/or
Part-Time / Subject and Qualification
Include any certificates and training
From / To
3.TRAINING
Include any relevant training courses and what you achieved, starting with most recent
Course Title / Objectives / Outcomes / Duration / Date Completed
4. PAID EMPLOYMENT / VOLUNTARY WORK / OTHER ACTIVITIES
Start with the most recent. For employment via an agency, give their details rather than the placement.
The Passage will use this information to take up references covering a minimum of the last three years and only once an offer of employment has been made. Please ensure you include full contact details.
Dates
Day/Month/Year / Employer
Full details / Details
For each paid employment/volunteering/bank work/other
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
From / Line Manager / Job Title
Contract Type
To / Organisation / Hours per week / Salary
Duties and responsibilities (brief summary)
Full Address
Email / Why you left
5. GAPS IN PAID EMPLOYMENT
Include details for each period e.g. unemployed, travelling, parenting
Date From / Date To / Explanation
6. EXPERIENCE / KNOWLEDGE / ABILITIES / SKILLS
Address each of the following key person specificationrequirements. For each, explain how you meet the criteria with recent examples. Keep to about 150 words per point and within no more than two A4 pages.
E1
E2
E3
E4
E5
E6
K1
K2
K3
K4
K5
Any other relevant skills or experience that you can bring to the role?
7.OTHER INFORMATION AND DECLARATIONS
The Passage aims to promote equality of opportunity for all with the right mix of talent, skills and potential. Applications from diverse candidates are very welcome. Criminal records will be taken into account for requirement purposes only when the conviction is relevant. If you are shortlisted for an interview for a role that requires a DBS (formally CRB) disclosure you will be asked to provide details of any cautions, reprimands or final warnings, as well as convictions.
Can you provide proof that you are able to work freely in the UK?(put an X in the appropriate boxes)
YES? / NO?
If yes, please provide details:
Are you related to or partner of a Passage Committee member or employee?
YES? / NO?
If yes, please provide details:
Have you ever been a Passage client and received services from us?
YES? / NO?
If yes, please provide details:
*** ALL INFORMATION CONTAINED IN THIS FORM WILL BE TREATED AS STRICTLY CONFIDENTIAL ***
By signing this application I certify that the information I have provided is true and accurate to the best of my knowledge; and that any deliberate withholding, omission or misrepresentation will be sufficient grounds for disqualification, and if employed, will leave me liable to disciplinary sanctions up to and including dismissal.
I declare that all of the information contained in this form is to the best of my knowledge correct. I also understand that any offer of employment will subject to a satisfactory identity check, references, heath clearance and if appropriate, DBS disclosure.
Signed/Typed by: / Date:

Thank you for your interest in The Passage