Application for Employment

Confidential

All applicants should complete this form and return it together with the equal opportunities form to: emma.cottrell@bexley.gov.uk or by post to: Hall Place and Gardens, Bourne Road, Bexley, Kent, DA5 1PQ by 5pm on the closing date. Hall Place is working towards equal opportunities and welcomes application from all sections of the community.

If you have any questions or have any difficulty in completing the form, please call on 01322 526574.

Personal Details

Surname (and title)

Forename

Address

Post code

Contact telephone number and convenient time(s) for us to contact youEmail address

Date of Birth

Please indicate any dates you will not be available to attend an interview.…………………………………………………………………………………...Please give details of any special arrangements or adjustments you would require to enable you to participant in our selection process effectively.……………………………………………………………………………………………………………………………………………………………………Do you require a permit to work in the U.K? Yes/No

If Yes, do you have one? Yes/No

Position applied for:……………………………………….………………………………………………………………

Do you have any connection with any of Hall Place’s present or past Yes/No

If yes, please give details……………………………………………………………………………….

Please tell us where you saw this post originally advertised?

…………………………………………………………………………………

Education and training

Please give details of all qualifications obtained and those being pursued. You may be required to provide evidence of qualifications where obtained. Secondary School

From To Qualification obtained and grades

Date obtained

College From To Qualification obtained and grades

Date obtained

University From To Qualification obtained and grades

Date obtained

Please give details of any work-related training you have undertaken.

Course title From To Subjects covered Course date

Most recent Employer (Paid or Unpaid)

Name of employer

Address of employer

Post code

Job title

Dates employed

Current or final salary

Reason for leaving (or seeking other employment)Please give an outline of your main responsibilities

Previous Employers (Paid or Unpaid)Name and address of employer

From To Job title and details of main responsibilities

Reason for leaving

Name and address of employer

From To Job title and details of main responsibilities

Reason for leaving

Name and address of employer

From To Job title and details of main responsibilities

Reason for leaving

If you have been dismissed or discharged by an employer, please supply details:

…………………………………………………………………………………

…………………………………………………………………………

Supporting Statement

Drawing from the job description, your work experience, education and training, outline how you satisfy the requirement of this job. Please provide information that directly applies to the role.

(Please continue on a separate sheet if necessary)

Other information

Please give details of your main interests and activities:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Please give details of any medical history or state of health that is relevant to this post:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

How may days of work/education have you missed in the last two years due to illness/injury? (Please give details.) ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

What notice period are you required to give your present employer?

…………………………………………………………………………………

If you were selected for this post, what would be your earliest start date?…………………………………………………………………………………..

Do you hold a current driving licence? Yes/No

Rehabilitation of Offenders Act, 1974

All appointments are subject to satisfactory security clearance. Please give details of any unspent convictions or cautions you have under the terms of the Rehabilitation of Offenders Act, 1974. Offences resulting in licence endorsements should be disregarded. Failure to disclose such information may result in dismissal or disciplinary action. This information will be treated as confidential and will not necessarily preclude you from employment. Do you have any criminal convictions?

…………………………………………………………………………………..

Are you subject to pending criminal proceedings?

…………………………………………………………………………………..

Referees

Please give details of two people, not related to you, who will provide an employment reference for you. One of these must be your present or most recent employer if you are not employed. The other should be a referee who can express a professional opinion on your work and ability to perform the job you are applying for. Name Name

Job title Job title

Name of organisation Name of organisation

Address Address

Contact telephone Contact telephone

Contact email Contact email

How long have you known this person and in what capacity?

How long have you known this person and in what capacity?

May we contact him/her prior to the interview?

May we contact him/her prior to the interview?

Declaration

I certify that the information contained on this application form is, to my best of my knowledge, correct. I understand that Hall Place reserves the right to withdraw any offer of employment or dismissal without prior notice.

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