Employment Application Form
Employment Application Form
Position Applied For: Early Morning Building Supervisor
This form should be completed in full. Please do not send a Curriculum Vitae (C.V.) as an
alternative to completing any section of this form. You may use additional sheets of paper
should there be insufficient space for your responses to any questions.
Your application will be judged solely on the information contained within this document in
accordance with the Person Specification supplied.
Safeguarding: Although you may not necessarily come into regular direct contact or
supervision of children and vulnerable adults, we would appreciate you completing the selfdeclaration form at the end of the application form, due to the confidentiality of
information you may process and events you may need to oversee in a position of trust and
responsibility.
Completed applications should be returned to ruth.barber@newcommunity.org.uk or post
to:
Ruth Barber
New Community
Central Hall
St Mary Street
Southampton
SO14 1NF
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Employment Application Form
Personal Details
Title:
Surname:
Forenames:
Address:
Post Code:
Telephone
(Mob):
Telephone (Home):
Email:
Have you lived at your address for at least five years?
Current Employment or Voluntary Position
Name, Address & Telephone Number of Current Employer
Position Held
Salary
Start Date
End Date
Brief Description of Duties
Reason for
Leaving
Notice Period
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Employment Application Form
Previous employment or volunteer experience
From
To
Employer
Position Held
Salary
Reason for
Leaving
Education and Qualifications
Name of Institution
Examinations & Subjects
Studied
Grade or
Award
Date
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Employment Application Form
Relevant training
Course Details
Date
Experience, skills and other information
Using examples to highlight, please state how your experience, developed skills and
achievements to date make you a suitable applicant for this position, with particular
reference to the Job Description and Person Specification for the position. If required,
please use the additional sheet overleaf.
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Employment Application Form
Experience, skills and other information continued
References
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Employment Application Form
References
Please supply the details of two people we can contact as referees, one of which must be
your present or most recent employer.
Name
Name
Address
Address
Position
Position
Telephone Number
Telephone Number
Email
Email
May we contact your referees prior to interview?
Yes
No
I certify that the information contained on this application form is accurate and true. I give
my consent to the processing, transfer and disclosure of all information submitted by me
during the recruitment process and throughout any subsequent periods of employment for
pre employment checks, equal opportunities monitoring, payroll operations and training.
(Data Protection Act 1988)
Print name:
Date:
Can you share how you heard about the position advertised?
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Employment Application Form
Private and Confidential
Self Declaration Form
For roles involving contact with children or vulnerable adults.
All information will be treated as confidential and managed in accordance with relevant data
protection legislation and guidance. You have a right of access to information held on you
under the Data Protection Act 1998.
Part One
For completion by individual:
Name:
Address and Postcode:
Telephone/Mobile No:
Date of Birth:
Gender:
Male
/
Female
For completion by the organisation if called for interview:
Identification (tick box below):
I confirm that I have seen identification documents relating to this person, and I
confirm to the best of my ability that these are accurate.
Either
UK Passport Number and Issuing Office
UK Driving Licence Number (with picture)
Plus
National Insurance Card or current Work
Permit Number
Signature of authorised Line Manager:
Print name:
Date:
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Employment Application Form
Part Two
NOTE: If the role you are in or have applied for involves frequent or regular contact with or
responsibility for children or vulnerable adults you will also be required to provide a valid
DBS (Disclosure and Barring Service) certificate which will provide details of criminal
convictions; this may also include a Barring List check depending on the nature of the role.
For completion by the individual (named in Part one):
Have you ever been known to any Children’s Services department
or Police as being a risk or potential risk to children?
YES
/
NO
(if Yes, provide information below):
Have you been the subject of any disciplinary investigation and/or
sanction by any organisation due to concerns about your behaviour
towards children?
YES
/
NO
(if Yes, provide information below):
Confirmation of Declaration (tick box below)
I agree that the information provided here may be processed in connection with recruitment
purposes and I understand that an offer of employment may be withdrawn or disciplinary
action may be taken if information is not disclosed by me and subsequently come to the
organisation’s attention.
In accordance with the organisation’s procedures if required I agree to provide a valid DBS
certificate and consent to the organisation clarifying any information provided on the disclosure
with the agencies providing it.
I agree to inform the organisation within 24 hours if I am subsequently investigated by any
agency or organisation in relation to concerns about my behaviour towards children, young
people or vulnerable adults.
I understand that the information contained on this form, the results of the DBS check and
information supplied by third parties may be supplied by the organisation to other persons or
organisations in circumstances where this is considered necessary to safeguard children.
Signature:
Print name:
Date:
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