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Reg charity no: 1075028 / Reg company no: 3716594

YMCA Reigate & Redhill - Application Form

Job Details

Post Applied for:

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Location

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Where did you see this post advertised?

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Personal Information

Title (*)

Please type your full name.
Surname

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First Name

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List below any other names by which you have been known

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Address

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Post Code

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E-mail Address (You need to provide an email address to confirm safe receipt of your form) (*)

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Home Telephone

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Mobile Telephone

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Work Telephone

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May we contact you at work? (*)

Please specify your position in the company


Official Information

ISA Registration Number (currently on hold due to government review)

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National Insurance No

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If appointed, how soon could you take up the post?

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Have you had any previous contact , or do you have any current contact with the YMCA? (*)

Please specify your position in the company
If Yes, please give details

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Do you hold a current Uk driving licence? (*)

Please specify your position in the company

Immigration, Asylum and Nationality Act 2006
It is a criminal offence to employ persons whose status prevents them from working in the United Kingdom. Prior to appointment, you will be required to provide evidence of a passport or other documents on the approved list to satisfy the Reigate and Redhill YMCA that the Immigration, Asylum and Nationality Act 2006 is being complied with.

Are you eligible to work in the United Kingdom? (*)

Please specify your position in the company
Do you need a work permit to work in the UK? (*)

Please specify your position in the company
If Yes, please give details below

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Education, Training and Development

Please list your academic and other relevant qualifications and dates passed starting with the most recent.

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Please describe other relevant learning opportunities (eg. training courses)

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Present or Last Employer

Employer's Name and Address

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Post held

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Date commenced

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If left, give date of leaving

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Reason for leaving

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Please give a brief description of your duties and responsibilities.

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Previous Employment and Experience

Please give details of previous paid employment

Job 1

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Job 2

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Job 3

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Skills and Experience

Please give details of any relevant skills/experience gained outside employment (e.g. through voluntary service).

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Supporting Information

Please detail how you meet the person specification for this post, illustrating with examples from work, voluntary or life experiences and stating why you are applying for this job.

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Please detail here anything else that you wish to tell us which is not already included in your application

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References

Please give the name and address of two referees, one of them should be your current or most recent employer, who can comment on your suitability for this post. If you were known by a different name, please also state this.and all subsequent amendments (England and Wales). For these positions you are not entitled to withhold information about police cautions, "bind-overs", or any criminal convictions including any that would otherwise be otherwise considered "spent" under the Act.

Referee 1

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Referee 2

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Personal Declarations

The position for which you are applying involves contact with children and/or vulnerable adults and is exempt from the Rehabilitation of Offenders Act 1974 and all subsequent amendments (England and Wales). For these positions you are not entitled to withhold information about police cautions, "bind-overs", or any criminal convictions including any that would otherwise be otherwise considered "spent" under the Act.

Have you ever been convicted of any offence or "bound-over" or given a caution? (*)

Please specify your position in the company
If Yes, please give details below

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I understand that if my application is successful I will be required to obtain an ISA registration and a CRB Disclosure at the appropriate level.

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DECLARATION - PLEASE READ CAREFULLY

For the purposes of the Data Protection Act 1998, I consent to the information contained in this form, and any information received by or on behalf of Reigate and Redhill YMCA relation to the subject of this form, being processed by them in adminstratering the recruitment process.

I give my consent for Reigate and Redhill YMCA to check my ISA registration and register an interest in me with the ISA as long as I am employed/volunteering with Reigate & Redhill YMCA.

I declare that the information I have given on this form is complete and accurate and that I am not banned or disqualified from working with children and/or vulnerable adults nor subject to any sanctions or conditions on my employment imposed by The Independent Safeguarding Authority, the Secretary of State or a regulaatory body.

I understand that to knowingly give false information or to omit any relevant information could result in the withdrawal of any offer of appointment, or my dismissal at any time in the future, and possible prosecution.

Print Name*

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Date:

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Enter the letters in the box
Enter the letters in the box

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* All candidates applying for employment online will be required to sign and date this form if invited to attend an interview.

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