Please complete this application form in ink or typescript; please do not enclose CVs, which will be disregarded – the application form has been designed to provide all necessary information.

Post applied for: 	   	
Surname:
		Mr		
		Mrs		
Forename(s):		Miss		
		Ms		
Address:		
Email:		
Tel. No. (Home): 	(Work):		(Mobile):		
NI No: 
Are you legally eligible for employment in the UK?	
Do you hold a driving licence?	Do you own a car?	
Please list any endorsements
 in the last five years

		
Do you consider yourself to be disabled?		
Do we need to make any reasonable adjustments in order that you can access our premises for an interview? (If yes, please specify below):	
Please indicate number of days off for illness in the past two years:
	
Name, address and telephone number of two referees. At least one should be your present or most recent employer or, if appropriate, a tutor. Please indicate in what capacity you know referees.	
1.	2.

Yes		No		
A reference from your present employer will be required but we shall not approach them without your permission. May we approach them now?	   

Education:

From	To	School/College/University	Degrees/Diplomas, Certificates
Or other qualifications. Please give dates.	

	

Please list any other relevant training: 

Training
	
Date	

		

Give details of your main interests and the depth to which these are pursued. 

Employment in chronological order, starting with present post:

Dates (Month and Year)
From:  To:	Name and Address of Employer	Position Held
Summary of Duties	Reason for Leaving	

Please outline main duties of your present or most recent post:

7

Please outline your experience to date, highlighting specific achievements relevant to the activities set out in the job description and person specification (continue on a separate sheet if necessary).

If offered, when could you take up appointment?		

Please note you may also be required to complete a DBS check for this post. 

I hereby declare to the best of my knowledge the information given on this form is true and correct and can be treated as part of any subsequent Contract of Employment.

Signed: 
	Date: 

NOTE: Any false statement within this application regarding qualifications or experience or any improper canvassing will result in disqualification.

Please ensure this form reaches us by 4.30pm, Wednesday, 21st October 2020. Interviews will be held via zoom during the week beginning 2nd November 2020.

Email completed application forms to: lynsey.collinson@developmentplus.org.uk
For any queries please call Lynsey Collinson, CEO – 07432 445481