Application for Employment

All sections of this form must be completed; failure to do so may result in non selection for interview

Post Applied For

Preferred hours of work 16 Hours 20 Hours 25 Hours 30 Hours Relief

Area Willing to Work Carlisle Wigton Penrith

Full Name (Including Title)

Surname at Birth (If Different)

NI Number

Nationality

Permanent Address (inc Post Code)

Address for Letters if different (inc Post Code)

Email Address

Fax

Home Telephone

Daytime Telephone (Where a message may be left)

Do You Hold A Current Driving Licence?

Do You Have Access to A Car?

Do You Have Any Current Endorsements

Please Specify

Are you eligible to be employed in the UK

Please indicate how you heard about this opportunity

Please Specify

Education

Name and Address of Institution

Date From

Date To

Subjects Taken & Grades

Level of Qualification

Full or Part-Time

More to Add?

Name and Address of Institution

Date From

Date To

Subjects Taken & Grades

Level of Qualification

Full or Part-Time

More to Add?

Name and Address of Institution

Date From

Date To

Subjects Taken & Grades

Level of Qualification

Full or Part-Time

More to Add?

Name and Address of Institution

Date From

Date To

Subjects Taken & Grades

Level of Qualification

Full or Part-Time

More to Add?

Name and Address of Institution

Date From

Date To

Subjects Taken & Grades

Level of Qualification

Full or Part-Time

Qualifications

Please give details, including dates, of any educational certificates, professional or other qualifications, with standard obtained, if applicable. Also include any NVQ & common induction/foundation courses relating to Health & Social Care.

Qualifications & Level Obtained

Awarding Body

Training Provider

Date Achieved

More To Add?

Qualifications & Level Obtained

Awarding Body

Training Provider

Date Achieved

More To Add?

Qualifications & Level Obtained

Awarding Body

Training Provider

Date Achieved

More To Add?

Qualifications & Level Obtained

Awarding Body

Training Provider

Date Achieved

More To Add?

Qualifications & Level Obtained

Awarding Body

Training Provider

Date Achieved

Training

Please give details, including dates of any work related training or other training you have successfully completed.

Course Title

Subject

Date

Relevant Information

More To Add?

Course Title

Subject

Date

Relevant Information

More To Add?

Course Title

Subject

Date Achieved

Relevant Information

More To Add?

Course Title

Subject

Date Achieved

Relevant Information

More To Add?

Course Title

Subject

Date Achieved

Relevant Information

Current Employment Information

Please give details of all full-time and part-time work, including any periods of self-employment

Name and Address of Most Recent or Present Employer

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

Previous Employment Information

Please give details of all full-time and part-time work, including any periods of self-employment

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

More To Add?

Name and Address of Previous Employers (Please list in order starting with the most recent)

Date From

Date To

Job Title and Nature of Work

Reason for Leaving (if appropriate)

Give details of any time not already accounted for (including unemployment & raising family)

Additional Information

Using the ‘Essential’ and ‘Desirable’ criteria outlined in the Person Specification, please provide relevant examples of your experience, knowledge, skills and abilities applicable to the post you are applying for.

Please give details of your hobbies and interests

Will you require any reasonable adjustments to be made to enable you to attend an interview

Referees

Please give details of two responsible persons to whom you are not related & to whom reference can be made. Your First referee must be your present or most recent employer.

First Referee

Name

Address

Post Code

Email Address

In what context does the first referee know you?

Second Referee

Name

Address

Post Code

Email Address

In what context does the second referee know you?

If you do not wish your present employer to be approached at this stage please indicate below

I give consent to my first referee (present employer) being contacted at this stage

Declaration

All information in this form will be treated as strictly confidential.

All successful applicants will be subject to an enhanced Disclosure and Barring Check. This is a requirement of the Care Standards Act 2000.

We have a positive approach to the recruitment and selection of ex-offenders, and all applicants are treated fairly.

However, failure to disclose any cautions or convinctions at this stage could affect your chance to volunteer.

Have you ever been cautioned or convicted of any offence?

Please give full details of offences (Please note that due to the nature of volunteering undertaken with vulnerable adults NO previous convictions can be classed as 'spent')

I confirm this application was completed by myself

If no, please state the reason why

I declare that the details given on this application are to the best of my knowledge and belief, true and complete. I understand that my application may be rejected or, if I am already appointed, I may be dismissed if I withhold relevant details or give false information. I hereby give my consent to the Company processing the data supplied on this application form for the purpose of recruitment and selection.

The Glenmore Trust needs to keep & process information about you for volunteering purposes. The information we hold and process will be used for our management and administration use only. The information you have given will be held in a secure manner and only shared with those who need to see it. If your application is shortlisted, your application form will be immediately destroyed and you will have to reapply in the future.

All the information you have provided throughout this application will be shared with the Skills for Care National Minimum Data Set (NMDS). For an explanation as to why NMDS need your information please visit www.skillsforcare.org.uk.

Signed

Date

Thank you for submitting your application.