Yes - A4ID



Post Applied for:Closing Date:Interview Date:Application FormTHE INFORMATION SUPPLIED ON THIS FORM WILL BE TREATED IN CONFIDENCE.Section 1 Personal detailsTitle:Last Name:First Names:Address:Postcode:Home Telephone Number:Mobile Telephone Number:E-mail address:National Insurance Number:Are you eligible to work in the UK?Yes FORMCHECKBOX No FORMCHECKBOX Please state current Salary Package including benefits & holidays: If you are successful you will be required to provide relevant evidence of the above details prior to your appointment.Section 2 EducationQualifications obtained from Schools, Colleges and Universities. Please list highest qualification first:College or University CourseQualifications and grades obtainedDates to be includedSchoolSubjectsQualifications and grades obtainedDates to be includedContinue on a separate sheet if necessaryProfessional, Technical or Management QualificationsProfessional/Technical/Management QualificationsCourse DetailsMembership of any Professional / Technical Associations- Please state level of Membership:Continue on a separate sheet if necessarySection 3 Employment RecordPrevious Employment (most recent employer first). Please state nature of business - if not public sector Dates of all positions needs to be includedName of Employer:Address:PostcodePosition Held:Period of Employment (years, months):Summary of duties:Reason for leaving:Name of Employer:Address:PostcodePosition Held:Period of Employment (years, months):Summary of duties:Reason for leaving:Name of Employer:Address:PostcodePosition Held:Period of Employment (years, months):Summary of duties:Reason for leaving:Name of Employer:Address:PostcodePosition Held:Period of Employment (years, months):Summary of duties:Reason for leaving:Name of Employer:Address:PostcodePosition Held:Period of Employment (years, months):Summary of duties:Reason for leaving:Continue on a separate sheet if necessarySection 4 Rehabilitation of Offenders ActHave you ever been convicted of a criminal offence that is not considered spent under the Rehabilitation of Offenders Act 1974?Yes FORMCHECKBOX No FORMCHECKBOX Have you any prosecutions pending?Yes FORMCHECKBOX No FORMCHECKBOX If yes, please give details / dates of offence(s) and sentence:Section 5Skills, Knowledge and ExperienceTaking particular account of the essential criteria listed on the Person Specification, please state what knowledge, skills and experience you have which are relevant to this post. Make sure that you give concrete examples to demonstrate your suitability. Please also state your reasons for applying.Continue on a separate sheet if necessarySection 6ReferencesPlease give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your referees are. By providing these details, you confirm that you are happy for us to contact these individuals to tell them that you have applied for this role and to ask them all that we consider relevant to your suitability for it. You agree that the information and opinions obtained by A4ID from your referees will be confidential between them and A4ID. .Reference 1Reference 2Name:Name:Their Position (job title):Their Position (job title):Work Relationship:Work Relationship:Organisation:Organisation:: :: :Address:Address:PostcodePostcodeTelephone No:Telephone No:E-mail:E-mail:Yes FORMCHECKBOX No FORMCHECKBOX Yes FORMCHECKBOX No FORMCHECKBOX Section 7DeclarationI confirm that the information provided in this application and within my Curriculum Vitae is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. Signed:Date:Section 8Recruitment Monitoring Form This sheet will be separated from your application form upon receipt and does not form part of the selection process. It will be retained purely for monitoring purposes and will not be looked at by anyone involved in decisions regarding selection for interview or appointment to the role.Application for the post of:To help us ensure that our Equal Opportunities Policy is fully and fairly implemented please COMPLETE THIS SECTION OF THE APPLICATION FORM.All questions are optional. You are not obliged to answer any of these questions but the more information you supply, the more effective our monitoring will be. All information will be treated in the strictest confidence and will not be placed on your personnel file. What is your Ethnic Group?Choose ONE section from A to E, and then tick the appropriate box to indicate your cultural background.A. WhiteD. Black or Black BritishWhite UK FORMCHECKBOX Black Caribbean FORMCHECKBOX Irish FORMCHECKBOX Black African FORMCHECKBOX White non-UK FORMCHECKBOX Any other Black background(please give details): FORMCHECKBOX Any other White background(please give details): FORMCHECKBOX B.MixedE. Chinese/Other Ethnic White & Black Caribbean FORMCHECKBOX Chinese FORMCHECKBOX White & Black African FORMCHECKBOX Vietnamese FORMCHECKBOX White & Asian FORMCHECKBOX Any other ethnic background(please give details): FORMCHECKBOX Any other Mixed background(please give details): FORMCHECKBOX C.Asian or Asian British Prefer not to say FORMCHECKBOX Indian FORMCHECKBOX Pakistani FORMCHECKBOX Bangladeshi FORMCHECKBOX Any other Asian background(please give details): FORMCHECKBOX GenderMale FORMCHECKBOX Female FORMCHECKBOX DisabilityDisability is defined as “physical or mental impairment, which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities”. An effect is long-term if it has lasted or is likely to last more than 12 months. Do you consider yourself disabled?Yes FORMCHECKBOX No FORMCHECKBOX If yes, please give details:Age Group16-25 FORMCHECKBOX 26-35 FORMCHECKBOX 36-45 FORMCHECKBOX 46-55 FORMCHECKBOX 56-65 FORMCHECKBOX 66-70 FORMCHECKBOX Over 70 FORMCHECKBOX MediaPlease state where you saw this post advertised ................
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