APPLICATION FORM

CLOSING DATE MIDNIGHT ON 15TH NOVEMBER 2015 / Lewisham Plus Credit Union Ltd, 262 Kirkdale, London, SE26 4RS
Tel. 0208 778 4738
We can only shortlist candidates on the basis of the information supplied on the application form. Please fill in the form and either return a hard copy to the above address or e-mail to

GUIDELINES

Personal details

If you wish to use a title, please give it with your surname, e.g. Ms, Mr, Mrs
Some of the questions on this page are related to monitoring our Equal Opportunities Policy. This page and its continuation sheet are removed before shortlisting. Please place a tick in the relevant box. / Post Applied for:CHIEF EXECUTIVE OFFICER
How did you hear about this Post ?
Surname:…………………………………………
Other names:……………………………………..
Address:………………………………………….
…………………………………………………...
Date of Birth: ……………………………………
Telephone no:……………………………....(home)
………………………...……………………(work)
Gender- 0 Female 0 Male
Describe your ethnic group:
White British / Indian
White other / Bangladeshi
Black British / Pakistani
Black Caribbean / Chinese
Black African / Vietnamese
Mixed ethnicity / Asian- other
Asian British / Other
Do you have a disability ?0 Yes0 No
Please state the nature of your disability if you consider it relevant.
------

Continued ………………………………………

/ Please outline any special facilities / equipment you may need to enable you to:
a)attend interview
b)and participate in meetings

Current situation:0 Unemployed

0Volunteer
0Employed
0Trainee

This sheet and the previous one will be removed before shortlisting

You should read the accompanying Job Description and Person Specification before completing this application form. Please ensure that you cover every areain the Person Specification and illustrate with examples.Remember that you can illustrate your skills by referring to experience gained outside paid employment.

Please note that CV 's are not accepted.

INITIALS:
1) EDUCATION AND PROFESSIONAL QUALIFICATIONS
Guidelines: Please tell us about your education & any professional qualifications which are relevant to the post, starting with the most recent.Please continue to add qualifactionsas necessary either on a blank page or by adding new rows electronically.Note that appointment will be subject to sight of original certficates.
School/Institution / Subject(s) / Level / Qualification / Date Gained
2) TRAINING / PERSONAL DEVELOPMENT
Please list any training or personal development you have undertaken, or courses which did not lead to a qualification, which you feel may be relevant to the post.
3 ) EMPLOYMENT HISTORY
Guidelines: You should start withdetails of your current or most recent employer and then continue in reverse chronology with details of previous employment.
Employer:
Dates from:
To:
Position held:
Current salary:
£ / Details of duties and responsibilities:
Notice period:
Previous Employer:
Dates from:
To:
Position held: / Details of duties and responsibilities:
Previous Employer:
Dates from:
To:
Position held: / Details of duties and responsibilities:
Previous Employer:
Dates from:
To:
Position held: / Details of duties and responsibilities:
Please continue to add employment history as necessary either on a blank page or by adding new rows electronically
4) PERSON SPECIFICATION
Please describe how you meet the criteria for the position. Continue either on a separate sheet or by extending the box electronically as necessary
1. Knowledge and qualifications
2. Experience
3. Skills and aptitutudes
4. Other requirements
5) FURTHER INFORMATION
Please add any further information which you consider to be relevant in support of your application
6. REFERENCES
Please provide details of two referees, one of which must be your current or most recent employer. References will only be requested once a preliminary offer of employment has been made and final offers will be subject to receipt of satisfactory references.
First referee
Name and title:
Address:
Telephone number:
e-mail address:
Second referee
Name and title:
Address:
Telephone number:
e-mail address:

I certify that the information given on this form is correct to the best of my knowledge. I consent to Lewisham Plus Credit Union Ltd checking any information provided in this application. I understand that the provision of false information in an application form may be grounds for disqualification or, if appointed, dismissal.

Signed:

Dated:

1