Employment Application Form Kids Can Achieve 29 Pinner Green Pinner Middx HA5 2AF 020 8868 5629

Please complete the form (in black ink) after you have considered the job description and person specifications for the post. In this way we hope to receive all the relevant information in support of your application.

Where did you see this post advertised?.......................................................................

PERSONAL DETAILS

Mr/Mrs/Miss/Ms/Other………………………………………DOB…………………………..

Surname……………………………………Forenames…………………………................

Address…………………………………………………………………………………………

……………………………………………………………Postcode………………………….

Phone (home)…………………………………….Mobile……………………………………

Ethnicity………………………………………………………………………………………..

Holder of current Driving License YES NO

NI Number…………………………………………………………….

Do you have any special needs…………………………………………………………….

REFERENCES

Please give two referees. One referee must be your current or most recent employer. If you do not wish us to contact your referees before interview, please place a cross in the box adjacent to the address.

NAME………………………………………………POSITION………………………………

ADDRESS……………………………………………………………………………………………………………………………………………………………………………………

NAME………………………………………………POSITION………………………………

ADDRESS……………………………………………………………………………………………………………………………………………………………………………………

EDUCATION ACHIEVEMENTS, TRAINING and QUALIFICATIONS

Please list all educational achievements, certificates gained, grades etc

Educational/Training Establishment

Qualifications gained

Date

List any courses, seminars and in-service training you may have attended which would be of significance in helping us to assess acquired skills or knowledge relevant to the job.

Training Establishment

Subject/skills/knowledge gained

Date

JOB HISTORY

Current/most recent employer

Name……………………………………………………………………………………………Address…………………………………………………………………………………………Job

Title………………………………………………………………………………………..

From…………………………..To………………………….Salary/grade…………………

Reason for leaving…………………………………………………………………………..

Period of notice required in present post………………………………………………….

Please give an outline of duties performed in the above job

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Other employment, paid or voluntary (most recent first)

Name……………………………………………………………………………………………Address…………………………………………………………………………………………

Job title………………………………………………………………………………………..

From…………………………..To………………………….Salary/grade…………………

Reason for leaving…………………………………………………………………………..

Name……………………………………………………………………………………………Address…………………………………………………………………………………………

Job title………………………………………………………………………………………..

From…………………………..To………………………….Salary/grade…………………

Reason for leaving…………………………………………………………………………..

Name……………………………………………………………………………………………Address…………………………………………………………………………………………

Job title….………………………………………………………………………………..

From…………………………..To………………………….Salary/grade…………………

Reason for leaving…………………………………………………………………………..

This post is exempt from the Rehabilitation of Offenders Act 1974.

Do you have any spent or unspent convictions? Yes No

If yes please give details …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

GENERAL COMMENTS

Please give details here of your specific reasons for this application, your main achievements to date, and the strengths you would bring to this post, or provide a CV and personal statement.

DECLARATION (please read this carefully before signing)

I confirm that the information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.

Signed……………………………………………………Date……………………………….

FOR OFFICE USE ONLY

Interviewed YES NO

Appointed YES NO