Job Application Form

Position applied for:		

Your details

Title		
First Name		
Surname		
Middle Name		
Preferred Name		
Full address

Postcode	

	
Mobile		
Home telephone 		
Email		

Education and Qualifications
Please list in chronological order, continue on a separate sheet if needed.

Qualification Title		
Qualification Type		
Grade		
Date		

Qualification Title		
Qualification Type		
Grade		
Date		

Qualification Title		
Qualification Type		
Grade		
Date		

Qualification Title		
Qualification Type		
Grade		
Date		

Qualification Title		
Qualification Type		
Grade		
Date		

Please give details of any professional bodies you are a member of.

Professional Body		
Membership Type		

Professional Body		
Membership Type		

Professional Body		
Membership Type		

Are there any other courses or training opportunities relevant to your application?

Employment History
Please list employment lasting 3 months or more beginning with the most recent, continue on a separate sheet if needed.

Date From	Employer	Job Title and summary of duties	Location	Reason for leaving	

Date to					

Date From	Employer	Job Title and summary of duties	Location	Reason for leaving	

Date to					

Date From	Employer	Job Title and summary of duties	Location	Reason for leaving	

Date to					

Date From	Employer	Job Title and summary of duties	Location	Reason for leaving	

Date to					

Date From	Employer	Job Title and summary of duties	Location	Reason for leaving	

Date to					

Are there any periods of non-employment that you would like to tell us about?

	

Summary of skills and experience 

Please use this section to tell us how you meet the criteria set out in the person specification. You should give as full an answer as possible with relevant evidence and addressing each of the points in the person specification.

	

Relevant information

Are you in current full time education or employment?	
    No                     Yes
                              How much notice do you need to give?

When would you be able to commence employment with us?		
Where did you see this post advertised?		

References
Offers of employment are offered subject to two satisfactory references. The JD will state what sort of references these should be (i.e. employment/personal or faith). Relatives are not an acceptable reference. We will not contact your references without your permission. 

Reference 1
Name	
	
Relationship to you		
Email address		
Phone number		
Job Title (if employment related)		

Reference 2 
Name	
	
Relationship to you		
Email address		
Phone number		
Job Title (if employment related)		

DBS check
Complete sections a or b depending on whether the role you have applied for is regulated or unregulated activity. If your role does not require a DBS check, you are not obliged to complete this section so any information you do give will be voluntary. The JD should tell you whether the role is eligible for a DBS and whether this is regulated or not.

a. Where a post involves regulated activity with children and/or adults

Workplace Matters is committed to safeguarding as an integral part of the activity of the charity. We believe everyone who participates with Workplace Matters activities is responsible for promoting a safe place. Any offer of employment is conditional on satisfactory clearance from a DBS check. If you are successful, you will be asked to submit a DBS application and confirm your understanding of our safeguarding policy.

The post you have applied for is exempt under the Rehabilitation of Offenders Act, and therefore we will request an enhanced DBS with a barred lists check. This means both spent and unspent convictions may be revealed. A DBS with disclosures does not automatically debar you from employment, but each case will be assessed fairly. 

1. Do you have any spent or unspent criminal convictions?                                      Yes   No
2. Have you ever received a caution, reprimand or final warning from the police?   Yes   No 
3. Have you ever been disqualified from working with children?                               Yes   No

If you have answered ‘yes’ to any of these questions please give full details, continuing on a separate sheet if necessary.

b. Where a post does not involve regulated activity with children and/or adults

Workplace Matters is committed to safeguarding as an integral part of the activity of the charity. We believe everyone who participates with Workplace Matter’s activities is responsible for promoting a safe place. Any offer of employment is conditional on satisfactory clearance from a DBS check. If you are successful, you will be asked to submit a DBS application and confirm your understanding of our safeguarding policy.

For the post, you have applied for under the Rehabilitation of Offenders Act, you only have to declare unspent convictions. A DBS with disclosures does not automatically debar you from employment, but each case will be assessed fairly. 

1. Do you have any spent or unspent criminal convictions?                                      Yes   No
2. Have you ever received a caution, reprimand or final warning from the police?   Yes   No 
3. Have you ever been disqualified from working with children?                               Yes   No

If you have answered ‘yes’ to any of these questions please give full details, continuing a separate sheet if necessary.

Disability
Workplace Matters encourages applications from people with disabilities, or those with health problems, who meet the essential criteria and will be given full consideration.

Do you have a disability under the definition of the Equality Act 2010?	Yes		No		
If YES, please give details and indicate whether you would need any help or special equipment to enable you to carry out the duties outlined in the job description, to attend for interview, or to participate in the recruitment process for the post.

	

Eligibility to work in the UK
Are you eligible to work in the UK and provide documentation?	Yes		No		
Are your required to have a work visa?	Yes		No		

Declaration
I confirm that:

•	The information provided in this application is true and correct to the best of my knowledge.

•	I understand any false knowledge may disqualify my application.

•	I consent to Workplace Matters processing my data including any “sensitive data” as is necessary to do so during the recruitment and selection process. 
	
Signed:
	
Dated:

If you have any questions about the application, please contact Mark Chester waterways@workplacematters.org.uk or 07718274111.

Please return your application form to our partners Church Army who are handling our recruitment administration  recruitment@churcharmy.org

We will try to acknowledge receipt of all applications where possible.