Application for Employment
Private and Confidential
Return this form to: Reference Number:
Position Applied for:
Personal Details
Title:
Name Forename(s):
Surname:
Address:
Post Code:
Contact
Information Email:
Tel No. (Home):
Tel No. (Mobile)
N.I Number:
Current Driving Licence
Yes: No:
Groups:
Expiry Date:
Details of Endorsement(s):
Are there any restrictions on you taking up Employment in the UK?
Yes: No:
If Yes, Please Provide Details:
Education (please complete in full and use a separate sheet if necessary)
Schools/College/University Names Qualifications Gained
Employment History (please complete in full and use a separate sheet if necessary)
Name of Employer:
Address:
Dates of Employment:
Last/Current Job Title:
Employment
Duties:
Rate of Pay:
Reason for Leaving:
Notice Period:
Name of Employer:
Address:
Dates of Employment:
Previous
Employment #2 Job Title:
Duties:
Rate of Pay:
Reason for Leaving:
Name of Employer:
Address:
Dates of Employment:
Previous
Job Title:
Employment #3
Duties:
Rate of Pay:
Reason for Leaving:
Current Membership of Professional bodies (i.e. CIPD, NMC)
Please note any professional bodies you are a member or registered with:
Other Employment
Please note any other employment that you would continue with if you were to be successful
in obtaining the position:
Leisure
Please note here your leisure interests, sports and hobbies, other pastimes, etc.:
References (please note here two persons from whom we may obtain both character and work references)
Title:
Forename(s):
Surname:
Address:
Reference #1
Post Code:
Contact No.
Position Held
May we approach the above prior to interview? Yes No
Title:
Forename(s):
Surname:
Address:
Reference #2
Post Code:
Contact No.
Position Held
May we approach the above prior to interview? Yes No
Please complete your availability below. You will be expected to work alternate weekends
Date 8am -2pm 2-8 pm 8pm – 8am
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
General Comments
Please detail here your reasons for this application, your main achievements to date and the strengths you would bring to
this post. Specifically, please detail how your knowledge, skills and experiences meet the requirements of this role (as
summarised in the person specification).
Criminal Record
The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020) provides that
when applying for certain jobs and activities, certain convictions and cautions are considered ‘protected’. This means that
they do not need to be disclosed to employers, and if they are disclosed, employers cannot take them into account.
Guidance about whether a conviction or caution should be disclosed can be found on the Ministry of Justice website.
Please note any criminal convictions except those 'spent', or otherwise ‘protected’, under the Rehabilitation of Offenders
Act 1974. If you have none, please state. In certain circumstances employment is dependent upon obtaining a satisfactory
Disclosure & Barring Certificate from the Disclosure & Barring Service/Disclosure Scotland.
Data Protection
1. We are aware of our obligations under data protection legislation, including the obligation to collect only the
data that is required for our specific purpose. The information collected in this application form is specific to
our recruitment exercise and necessary for the performance of the role that you have applied for. If you are
recruited for the role you have applied for, or any other role you are offered by us, the information provided
will then be used for the purposes of your employment with us, together with further information collected
upon recruitment for those purposes.
2. We will treat all personal information about you with utmost integrity and confidentiality. Our data protection
policy sets out our approach to ensuring that your data is processed in line with the data protection principles
within current data protection legislation.
3. Our privacy notice for job applicants gives you information on, amongst other things, the data we will hold
about you during the recruitment exercise and what we use it for. A copy of the privacy notice is attached to
this application form.
Declaration (please read this carefully before signing this application)
1. I confirm that the information provided in this application is complete and correct and that any untrue or
misleading information will give my employer the right to terminate any employment contract offered.
2. Should we require further information and wish to contact your doctor with a view to obtaining a medical
report, the law requires us to inform you of our intention and obtain your permission prior to contacting your
doctor. I agree that the organisation reserves the right to require me to undergo a medical examination.
3. I agree that should I be successful in this application, I will, if required, apply to the Disclosure & Barring
Service/Disclosure Scotland for a Disclosure & Barring Certificate. I understand that should I fail to do so, or
should the disclosure not be to the satisfaction of the company any offer of employment may be withdrawn or
my employment terminated.
Date
Signed:
:
Revised June 2021
