The Prison Reform Trust

The Prison Reform Trust

15 Northburgh Street

London EC1V 0JR

Tel: 020 7251 5070

Name:
Last / First
Address:
Street Address
Town/City / Post Code
Phone: / () / E-mail :
Position Applied for:

Please give the name and address of two people to whom we may apply for references. One should be your current or most recent employer, the other someone who is able to comment on your skills

and your employment record. These individuals should not be personal or family friends.

Full Name: / Relationship:
Company: / Phone: / ()
Address:
Email:
Full Name: / Relationship:
Company: / Phone: / ()
Address:
Email:
Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Ending Salary: / £
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO
Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Ending Salary: / £
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO
Company: / Phone: / ()
Address: / Supervisor:
Job Title: / Ending Salary: / £
Responsibilities:
From: / To: / Reason for Leaving:
May we contact your previous supervisor for a reference? / YES / NO

Please list your school and college or university experience with details of any qualifications obtained.

Year / Qualification / Grade / Educational Establishment

Training-please list details of any relevant training courses you have attended.

Details of course/s / Date/s / Duration

Unpaid/voluntary work-please list details of any undertaken.

Date/s / Organisation / Nature of work

Please say why you are applying for the post and how you meet the essential and desirable criteria on the person specification, (maximum 1000 words) .

I agree that Prison Reform Trust may hold and use the information about me contained in this application, including any information which falls within the definition of ‘sensitive personal data’ under the terms of the Data Protection Act 1998, for the purposes of processing this application and for personnel reasons if an offer of employment is made.

I confirm that the information on this form and any attachments is correct and complete. I understand that any information later discovered to be incorrect may result in the termination of any agreements made.

Signature

Date

Please return your completed form and monitoring form by email to Ms Sam O’ by post to the address on the front page of this form by

9:00amon Monday 14th September 2015