Wolverhampton City Credit Union Ltd

Wolverhampton City Credit Union Ltd, 73 Worcester Street, Wolverhampton, WV2 4LE

Telephone: 01902 – 572340 e-mail:

Application Form

Please type or complete this form in black ink and return it the address above. This sheet will be detached and will not be seen by the recruitment panel.

Position
/

Assistant Manager

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Ref
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AM2013

Surname (Block Capitals)
First Name(s)
Home Address:
Post Code:
Home Telephone No: / Date of Birth:
Day Telephone No: / National Insurance No:
Mobile Telephone No: / Criminal Convictions:
YES / NO

Criminal Convictions

The position you are applying for is not exempt from the Rehabilitation of Offenders Act 1974. Please give details of any “unspent” convictions.
In the event of employment, failure to disclose appropriate information about convictions may result in dismissal or disciplinary action. Information given will be completely confidential.
If you have been convicted of any offence or if there are any proceedings pending against you, please give details:
This post will be subject to an enhanced Criminal Records Bureau check.

References: Please write the names and addresses of two people who can comment on your ability to carry out the duties of this position. If you are currently employed, one of the references must be from your present employer. If you are not employed, it would be desirable if one reference was from your previous employer, or a person who knows you well.

Reference
/
Reference
Name: / Name:
Address: / Address:
Post Code: / Post Code:
Note: References will only be taken up until after the interview

Declaration:

I understand that the appointment, if offered, will be subject to the information form being correct. I also understand that that the appointment will be subject to satisfactory references. I certify that the information which I have given is to the best of my knowledge true and accurate

Signature: / Date:

Employment Details

Present Employer

Name & Address of Employer / Position Held
Current Annual Salary
Date Appointed
Are you in possession of a valid Driving Licence?
Yes / No
Brief description of duties and levels of responsibility:
Date Left/Period of Notice Required
Reason for Leaving

Previous Employment

Employer / Job Title, Brief Outline of Duties & Salary / Dates From/To
Salary: / £
Salary: / £
Salary: / £
Salary: / £

Health

Number of days absent due to illness in the past 12 months: / Number of instances of absence due to illness in the past 12 months:
You may provide details should you wish to do so:
Please Indicate any disease, physical or mental impairment, which causes a substantial and long term adverse effect on you ability to carry out day to day activities

Qualifications

Please give details of your secondary and further education, including any professional qualifications or certificates you hold.

Qualifications and/or examinations passed / Date / Level / Grade Achieved
Details of membership to professional body (if applicable)
SPECIAL TRAINING – Including any relevant courses you have taken
Title of Course / Organised by / Length of Course

Details of relevant experience and your reason for applying for this post

Please give details of how you relate your education, training and life experiences to the requirement of this position for which you are applying. Include references to unpaid voluntary/community/leisure activities which are relevant. The selection will be based principally on how well you are able to demonstrate to the panel that you satisfy the selection criteria. Please continue on a separate sheet if necessary. PLEASE DO NOTATTACH C.V’s as these may jeopardise you application.