Job Application Form

1. Position applied for

Position applied for: *

2. Personal details

Title

First Name *

Surname *

Address 1 *

Address 2 *

Town/City *

County *

Postcode *

Telephone Number *

Alternative telephone number *

Email Address *

National Insurance number *

Date of birth *

3. References

Please give the names of two referees, neither of whom should be family members. One reference must be your current or most recent employer. They will not be contacted prior to any interview.

Referee 1 name *

Organisation *

Full postal address *

Telephone number *

Email address *

In what capacity do you know them? *

Referee 2 name *

Organisation *

Full postal address *

Telephone number *

Email address *

In what capacity do you know them? *

4. Education

Please give details of all education including secondary, further and higher education in chronological order, starting with the most recent.

Place of education 1 *

Attended from *

Attended until *

Grades obtained *

Place of education 2 *

Attended from *

Attended until *

Grades obtained *

Place of education 3 *

Attended from *

Attended until *

Grades obtained *

Place of education 4 *

Attended from *

Attended until *

Grades obtained *

5. Employment

Please give details, in chronological order, of any employment held since secondary school, starting with your most recent post. Please explain any gaps in your employment. If you require more room, please use the "Additional Information" in Section 8.

Employer 1 *

Position held *

From *

Until *

Salary *

Main duties of the role *

Reason for leaving *

Employer 2 *

Position held *

From *

Until *

Salary *

Main duties of the role *

Reason for leaving *

Employer 3 *

Position held *

From *

Until *

Salary *

Main duties of the role *

Reason for leaving *

Employer 4 *

Position held *

From *

Until *

Salary *

Main duties of the role *

Reason for leaving *

6. Training & personal development

Please provide details of any training or personal development you feel may be relevant to the role.

7. Information in support of your application

Please explain how your skills and experience meet the requirements detailed in the person specification. This must be linked, point for point, to the person specification, please evidence both the essential and desirable criteria where possible.

8. Additional Information

If you wish to make a statement in support of your application, please do so in the space provided.

Are you a car owner? Yes No

Are you a car driver? Yes No

Do you hold a full valid UK licence? Yes No

Statement re the Rehabilitation of Offenders Act 1974 (Exceptions) Order (as amended in 2013) :

Do you have any convictions, cautions, reprimands or final warnings that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)? Yes No

The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are protected and are not subject to disclosure to employers, and cannot be taken into account.

All guidance and criteria on the filtering of these cautions and convictions can be found here.

Do you wish to be considered for a job interview under the job interview guarantee scheme (due to a disability)? Yes No

If selected for interview/called for interview under the job interview guarantee scheme do you require any reasonable adjustments to the interview process? Yes No

If yes, we will contact you for further information.

Please declare any previous incidents or investigations including malpractice or misconduct relating to an adult or child that may have been reported to a regulatory body. *

Please note: The DBS requirement of this post is detailed on the advert and Person Specification

I confirm that the information given in this form is correct. Yes

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