Reach Cambridge - Supervisor Application
Personal details
Title
Name
Surname
Street address
Home address
(for contact
purposes):
Town/city
County
Post code
Country of
residence:
Right to work
in the UK:
Contact
details:
UK
Other
Yes
No
Mobile:
If other please state:
Do you require a work permit or VISA?
Yes
No
Email:
NI number:
Knowledge, experience and skills
(a) Please tell us why you are applying to be a supervisor at Reach Cambridge and what knowledge and skills you will bring to
the role.
(b) Please tell us about the challenges and rewards of working with young people from a variety of countries. Please refer to
your experiences where possible.
Referees
Please provide the contact details of two referees (covering the last three years), one of whom should be your current
employer (see process flow chart for an indication of when your referees will be contacted)
Name
Name
Job title
Job title
Organisation
Organisation
Relationship to you
Relationship to you
Address
Address
Tel
Tel
Mobile
Mobile
Email
OK to contact?
Yes
Confidential Information
No
Email
OK to contact?
Yes
No
Reach Cambridge requires all employees to undertake an enhanced DBS. You are required, before appointment, to disclose
any conviction, caution or binding over including ‘spent convictions’ under the Rehabilitation of Offenders Act 1974
(Exemptions) Order 1975.
Non-disclosure may lead to termination of employment. However, disclosure of a criminal background will not necessarily
debar you from employment – this will depend upon the nature of the offence(s) and when they occurred.
In relation to the above, if you have any convictions or cautions (including spent convictions) you are obliged to detail these
below:
Do you have any convictions (including cautions and bind-overs)?
Yes
No
I can confirm that I am not on List 99, disqualified from working with children or subject to sanctions imposed by a regulatory
body such as the General Teaching Council.
Date:
Signature:
Please note that you will be requested to personally sign the declaration above, should you be called for interview. In the
interim we accept a typed signature
Declaration
Information from this application may be processed for purposes registered by the Employer under the Data Protection Act
1984 and 1998. Individuals have, on written request and on payment of a fee of £10 the right of access to personal data
held about them.
I hereby give my consent to Reach Cambridge Ltd processing and retaining the data supplied in this application form for an
appropriate period of time for the purpose of recruitment, selection and employment.
I declare that the details given by me on this application form are correct to the best of my knowledge and belief.
I understand that if I give any information which is false, or I withhold any relevant information, this may lead to my
application being rejected, or if I am already appointed, to termination of employment.
Please note that you will be requested to personally sign the declaration above, should you be called for interview. In the
interim we accept a typed signature.
Please tick the box and sign below to agree to confirm that you have read, understood and agree with the above declaration
Yes
Date:
Signature:
Please note that you will be requested to personally sign the declaration above, should you be called for interview. In the
interim we accept a typed signature