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Apply online to better the lives of young people.

  • Personal
  • Employment
  • Education
  • References
  • Declaration

Position

Position Applied For

Personal Details

Surname

Forename(s)

Have you been known by any other name(s), if yes please specify

Title

(if 'other' please state your title)

Address

At the above address since?

If under 5 years please note all other addresses for the last 5 years below There must be no gaps in dates however overlapping dates are acceptable:

Address

At the above address since?

Address

At the above address since?

Home Phone Number

Mobile Number

Email Address

Do you hold a Driving Licence

Please detail any Endorsements

Do you have regular use of a:

(if 'other' please state here)

Are you or have you ever been debarred from working with children or vulnerable adults?

Employment History

Please provide details of all your employment history including any temporary employment; please list your employment positions in reverse chronological order (i.e. most recent first). Continue on additional pages if necessary. Where previous employment (whether paid or unpaid) has been with children or vulnerable adults, you must show your reason for leaving this employment.

Current of most recent employer

Position Held

Period Employed From – To

Reason for leaving

Notice Period

Annual Salary

What were your main tasks, duties and responsibilities?

Previous employment part 2

Previous Employer

Position Held

Period Employed From – To

Reason for leaving

Notice Period

Annual Salary

What were your main tasks, duties and responsibilities?

Information about any gaps in employment history

Education History

Secondary School Attended

From - To

Examinations Passed

Further/higher education establishments attended

Qualifications Gained

Training courses Relevant to the post applied for (including Dates)

References

Should you be successful in your application, the company will take require two references, these must provide the last three years of employment if you have been employed. Use additional referees

Reference 1- Most Recent employer

Surname

Forename(s)

Job Title

Address (Inc. post code)

Phone Number(s)

Email

Reference 2

Surname

Forename(s)

Job Title

Address (Inc. post code)

Phone Number(s)

Email

Have you been subject to any of the following?

Disciplinary

Suspension

Dismissal

If yes please provide details below

If offered employment, we are required to check your DBS status before you are permitted to start work. Do you have a DBS certificate

If yes are you a current member of the update Services

If yes, do you consent to this update service check being made by the company

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) by SI 2013 1198

If yes (to the above question) please provide details including dates

Are there any criminal proceedings pending?

Additional Information

You may also want to include any skills, abilities, hobbies and experience you have that are relevant to the position for which you are applying.

Additional Information

Declaration

I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable to summary dismissal. I understand these details will be held in confidence by the company, for the purposes of ongoing personnel administration and payroll administration in compliance with the Data Protection Act 1998. I undertake to notify the company immediately of any change to the above details. Given the nature of the job for which I have applied, I understand that any offer of employment will be subject to information on my criminal record being disclosed to the company by the Disclosure Barring Service. (please note 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. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service Website.

Print Name

Date