Five Rivers Application form

Post applied for

Full time
Part time

Source of advertisement

Have you done this work before

By Phone

Yes
No

By Email

Yes
No

Do you need a work permit?                       

National Insurance Number

References

Please give names and addresses of 3 referees who can comment on your ability to carry out the job applied for. We require 2 employment referees - one must be your present employer, and if unemployed your last employer. If you are a student then your college tutor.

References will normally be taken up for short-listed candidates only, prior to interview unless you indicate to the contrary. Referees will be asked specifically about your health, sickness and disciplinary record. Please note that we cannot accept referees who are directly related to you.

References can be requested from any of the previous employers given.

1. Present employer            

Can be contacted

NAME

POSITION

2. Previous employer

Can be contacted

NAME

POSITION

3. Previous employer

Can be contacted

NAME

POSITION

Details of Secondary / Further Education
(Qualifications Gained / Grade School/College/University)

Professional Qualifications / Membership of Professional Bodies

Relevant Experience / Skills:
Give details of any achievements, career plans or particular areas of work experience (including voluntary work), which you feel is most relevant to this post.

Present Employment Details (if applicable)

Job Title

Please state number of days absent from work due to sickness in the last 2 years

Previous Employment (starting with the most recent, and dates must be shown)

The space below provides you with the opportunity to tell us about your work and education experience. Please show details of any times when you have not been in employment or education.

Employment

Relationship

Are you related or do you know anyone working for Five Rivers:
If yes please give details (e.g. name and relationship)

Health
(please note any References will be asked specifically about your health & sickness record)

Number of Days absent from work due to sickness in the last two years

Details of any illness or operations in the past 5 years, which could affect your ability to adequately perform your job which you are applying.

Are you Registered Disabled?

Why do you think we should consider you for this post?

How would you describe yourself through the eyes of a colleague?

What would you like be doing in five years time?

Rehabilitations of offenders act 1974 (exemptions) order 1975

BECAUSE OF THE JOB IN WHICH YOU ARE APPLYING FOR INVOLVES WORKING WITH CHILDREN UNDER THE AGE OF 16 WE ARE OBLIGED TO ASK YOU TO DISCLOSE ALL CONVICTIONS AND CAUTIONS WHICH OTHERWISE MIGHT BE CONSIDERED ‘SPENT' IN THE EVENT OF EMPLOYMENT. FAILURE TO DISCLOSE SUCH INFORMATION COULD RESULT IN DISSMISSAL OR DISCIPLINARY ACTION.

THIS INFORMATION WILL BE TREATED AS STRICTLY CONFIDENTIAL.

Please note that you will be subject to an enhanced Criminal Record Bureau Check in the event of employment being offered. Five Rivers is committed to equal opportunities in Employment.

Pre Interview Questionnaire

Please take time to complete the following section as part of your application.
As you maybe asked to elaborate further at interview.

Looking at the requirements of the job  please give 3 brief separate examples of how you believe your skills and competences could be demonstrated by using the person specification and job description.

Example (1)

What you did (the situation and/or task):

How you achieved (what part you played in this)

Example (2)

What you did (the situation and/or task):

How you achieved (what part you played in this)

Example (3)

What you did (the situation and/or task)

How you achieved (what part you played in this)

Data Protection Statement

The information you supply on the application form will be used to assess your suitability for the post applied for (or another relevant post). These details will only be disclosed to those persons involved in the selection process or personnel administration.

Five Rivers will retain the forms of unsuccessful applicants for a period of 4 months to enable interview feedback and any issues that may be raised, after this time all recruitment information will be destroyed by shredding.

Should you be successful, this form will be placed in your personnel file and retained during your employment with Five Rivers, and for as long as legislation dictates when working with young people. We will protect your information, and treat it as confidential at all times.

I confirm that the facts given in this application are true and correct, and understand that any misinterpretation will invalidate my application.

I understand that any false information may result in my dismissal, if appointed.

I am prepared to undergo a medical examination if requested, and confirm that to the best of my knowledge, there are no medical reasons which would prevent me from undertaking the duties of the post.

Personal Declaration   

I can confirm that the information I have provided is true and correct and I understand that any Misinterpretation will invalidate my application.

I am prepared to undergo a medical examination if requested and confirm that to the best of my knowledge there are no medical reasons which could prevent me from undertaking of the duties of the post.

If you agree with the above please submit your details and you will be contacted shortly.

We would like to thank you in advance for taking the time to complete this application.