About You

In accordance with Wood Green Animal Centre’s Equal Opportunity policy, the organisation will provide equal opportunities to any job applicant or employee and will not discriminate directly, or indirectly, on the grounds of race, religion, sex, sexual orientation, marital status, disability or age.

We would be grateful if you would complete the questions on this form. We have asked for your name to enable us to monitor applications at shortlisting and appointment as well as application stage.

All information will be treated in confidence and will not be seen by staff directly involved in the appointment. The questionnaire will be detached from your application form, stored separately and used only to provide statistics for monitoring purposes. Thank you for your assistance.

Title: Mr/Mrs/Ms/Miss/Dr First name: Surname:

Address:

Postcode:

Home Telephone: Mobile:

Email:
Work Telephone: May we contact you at work? Yes/No

National Insurance Number:
Do you hold a clean UK driving licence? Yes/No Do you have your own vehicle? Yes/No
If no, what arrangements can you make to travel to work?
Do you have any allergies that would affect your ability to work with animals?

Date of last tetanus injection:
Your surgery will be able to tell you whether you need a tetanus booster. This must be up to date.
Post Reference:

  1. Gender: Male Female
  1. Age:

  1. Date of Birth:

  1. Marital Status: Married Single Other

  1. Do you have responsibility for dependants? (Eg Children, elderly or other persons for whom you are the main carer)
Yes No
  1. Do you have any disabilities?
Yes No
  1. Ethnic Origin:

Black Caribbean Bangladeshi

Black AfricanPakistani

Black OtherAsian Other

ChineseWhite

IndianOther
8. Have you ever been convicted of a criminal offence? Yes/No
Please note that criminal convictions need not be disclosed, except for specific occupations, if they are spent within the meaning of the Rehabilitation of Offenders Act.
Data Protection: Information from this application may be processed for purposes registered by the Employer under the Data Protection Act 1998. Individuals have, on written request (and on payment of a fee) the right of access to personal data held about them.
I hereby give my consent to Wood Green Animal Shelters processing the data supplied in this form for the purpose of recruitment and selection.
Applicant’s signature:

Your Application

Please print clearly

Position
Application for the position of:
Job Reference:
How did you hear of this vacancy?

Working schedule: Full Time/Part Time*
*Please give details of hours wanted, if applicable:

Skills

Please describe the skills, knowledge and qualities relevant to the role that you have to offer Wood Green Animal Shelters.
Education
Names & addresses of Schools/Colleges attended since age 11 / Qualification / Subject/Course / Grade/Result
You may be required to show proof of any qualification gained at interview
Employment
Please complete this section of the form as fully as possible with your past and present employment experiences (including holiday work and work experiences). Start with your current or most recent employer and work backwards, including any periods when you were not working, with details. Continue o a separate sheet if necessary.
Position held / Name & address of employer / From Mnth/Yr / To Mnth/Yr / Last Salary / Outline of Duties & Responsibilities / Reason for leaving
Personal Development
Please outline your career and development aims
Interests
Please describe your spare time interests, hobbies and sports, membership of clubs, professional bodies and societies.
Additional Information
Notice period for current employment / your availability

Is there anything else that you would like to tell us? (If this is a speculative application, please indicate your minimum salary requirement, if you have one)
References
Please give the names and addresses of two people (un-related to you) who are willing to provide a confidential reference regarding your character and general suitability for the position for which you have applied. You must provide two referees, one of whom must be your current or most recent employer.

Name:
Occupation/position:
Company name:
Address:


Telephone:
Fax:
Email:
/
Name:
Occupation/position:
Company name:
Address:



Telephone:
Fax:
Email:

I understand that any appointment, if offered, will be subject to the information on this application form being correct, and that this will form part of any employment agreement entered into with Wood Green Animal Shelters and Associated Subsidiaries. I understand that the information will be stored in manual and electronic files and is subject to the provision of the Data Protection Act. I agree to information provided on this form being used by the Shelters in accordance with the Act and, in particular, for equal opportunities monitoring. I understand that I may be required to submit to a medical examination by the Shelters’ medical advisor.
Signed:Date:

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