Application Form Position applied for Date of application Your details Title: ---MrMrsMissMsDr First name Middle name Surname Known as Email address Contact telephone number Address including post code Next of kin / emergency contact details Statutory requirements (The Children and Young Persons Act 1993) To ensure statutory requirements relating to young workers are met please answer the following question. Are you under 18?YesNo If Yes please enter your date of birth Right to work in the UK (Asylum and Immigration Act 1996) I can provide confirmation that I am legally entitled to work in the UK YesNo You’ll need to produce original documents to prove your eligibility at the interview/assessment stage. Reasonable adjustments (The Equality Act 2010) Do you have any special requirements we should know about if you’re invited to an interview/assessment? YesNo If Yes please give details: Employment history for the last five years (Please start with current or most recent) Current/last employers name Address including post code Period of employment Position held Main duties / responsibilities Reason for leaving Please use this area to provide additional previous employment history Please tell us about any periods of non-employment (if applicable) Education Please give details of the School/College/University, dates attended and grades / qualifications achieved Please give details of any technical or professional qualifications and dates awarded Please give details of any further training courses attended that are relevant to your application You and your application Please tell us why you have applied for this job and why you think you are the most suitable candidate (max 250 words) Please tell us about your hobbies / interests Rehabilitation of offenders Have you been convicted of a criminal offence which IS NOT spent under the Rehabilitation of Offenders Act 1974? YesNo If Yes please provide details Applicant’s declaration By ticking this box you are agreeing to the following terms: I declare that to the best of my knowledge and belief the information contained in this application is correct. I accept that providing deliberately false or misleading information may result in my dismissal. I consent to this information being held on file and treated as part of any subsequent contract of employment. Please ensure you've ticked the declaration box above before submitting your application.