ASLEF - Health and Safety Advisor

APPLICATION FORM

All applications will be treated in the same way regardless of their race, gender, disabilities, sexuality, age or other status.

Position: Health and Safety Advisor
Where did you see this post advertised?
PERSONAL DETAILS
Family name…………………………………….. Other names………………………………………….
Address …………………………………….. Tel. No. (Home)…………………………………….
…………………………………….. Tel. No. (Work)…………………………………….
……………………………………… Mobile No: ………………………………………….
Do you need a work permit, visa or any other type of documentation to show that you have the necessary permission to stay and work in the UK? YES/NO
Period of Notice ………………………………..
National Insurance No……………………………….. What is your current salary …………………….
REFERENCES
Please give name, address of two referees, one of which must be your present or most recent employer and excluding relatives. References will not be taken up until after the selection process and a job offer is being made.
Name:
Address:
Position:
Occupation:
How is the Referee Known to you?
Telephone No. / Name:
Address:
Position:
Occupation:
How is the Referee Known to you?
Telephone No.
EMPLOYMENT HISTORY
PRESENT OR MOST RECENT EMPLOYER
Company Name:………………………………………………………………………………….
Position Held:……………………………………………………………………………
Outline Description of Duties………………………………………………………………………………….
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Employed From/To:……………………………………………No. of sickness days………………………
Reason for Leaving:……………………………………………………………………………………………
Company Name:………………………………………………………………………………….
Position Held:……………………………………………………………………………
Outline Description of Duties………………………………………………………………………………….
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Employed From/To:…………………………………………No. of sickness days ………………………..
Reason for Leaving:……………………………………………………………………………………………
Company Name:………………………………………………………………………………….
Position Held:……………………………………………………………………………
Outline Description of Duties………………………………………………………………………………….
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Employed From/To:…………………………………………No. of sickness days…………………………
Reason for Leaving:……………………………………………………………………………………………
Please use additional blank sheets for employment history
OTHER RELEVANT WORK
(i.e. Work Experience/Voluntary/Unpaid)
EDUCATION & QUALIFICATIONS
Subject / Level/Qualification / Date Gained

Please use additional sheets if necessary.

PROFESSIONAL MEMBERSHIPS AND QUALIFICATIONS
RELEVANT TRAINING/COURSES
DISABILITIES
Do you consider yourself to have a disability? Yes □ No □
Please give brief details…………………………………………………………………………………………..
We ask this information so that suitable interview arrangements can be made if necessary.
The information supplied in this application form is accurate to the best of my knowledge.
Signed Date
SUPPORTING STATEMENT
Please use this space to supply additional information to support your application.
It is vital that all applicants, both internal and external, complete this section in full. We need as much relevant information as possible to decide whether or not to invite you for assessment.
You should clearly state why you are applying for the post and provide specific evidence, which demonstrates how you meet the stated essential criteria in the personal specification for the post. Please write underneath each criterion listed below giving examples to show how you meet the requirements.

Please use additional sheets if necessary.

EQUAL OPPORTUNITIES MONITORING FORM

In order to assist us in monitoring the effectiveness of our Equal Opportunities policy, we would appreciate it if you could answer the questions below

Post Applied for Ref:
Gender:
Male  Female 
Ethnic Origin

Asian or Asian British

/ Mixed

 Bangladeshi

/  White and Asian

 Indian

/  White and Black African
 Pakistani /  White and Black Caribbean
 Other Asian Background /  Other Mixed background

British or Black British

/ White

 African

/  British
 Caribbean /  Irish
 Other Black background /  Other White background
Disability:
Do you consider yourself to have a disability? Yes No
Age:
Under 25 25 - 34 35 - 44
45 -54 55 - 65