Application Form

Date From * Date To * School / College / University * Qualifications Gained *
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Please note any professional bodies you are a member of or are registered with.

Please note here any other employment you would continue with if you were to be successful in obtaining this position.

Please note here your leisure interests, sports and hobbies, other pastimes, etc.

Please note here the names and addresses of two people from whom we may obtain work reference. One must be your current/last employer.

Name * Position * Address * Postcode * Telephone * Email May we approach them prior to interview?
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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).

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Exceptions Order 1975 as amended by the Exceptions (Amendment) Order 1986, which means that convictions that are spent under the terms of the Rehabilitation of Offenders Act 1974 must be disclosed, and will be taken into account in deciding whether to make an appointment. Any information will be completely confidential and will be considered only in relation to this application. In addition you are required to submit to a Disclosure and Barring check/provide a PVG Scheme Record or Scheme Record Update. Any disclosure made by the Disclosure and Barring Service/Disclosure Scotland will remain strictly confidential. Have you ever been convicted in a Court of Law and/or cautioned in respect of any offence?

1. I confirm that the above information 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. In addition, I agree that this information will be retained in my employee file during employment and for up to six years thereafter and understand that information will be processed in accordance with the Data Protection Act.

3. I agree that my previous employers may be approached for references. I also agree that should I be successful in this application, I will apply to the Disclosure and Barring Service/Disclosure Scotland for a Disclosure and Barring certificate/PVG Scheme Record or Scheme Record Update. I understand that should I fail to do so, or should the disclosure or reference not be satisfactory, any offer of employment may be withdrawn or my employment terminated.