1 King's Bench Walk - Staff Applications

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Staff Application Form

If you need any assistance with the application process please contact Sue Gray on 0207 936 1500.

Title of post applied for:

Title:

Your details

Title:

Forename(s):

Surname(s):

Address:

Postcode:

Telephone (Daytime):

Telephone (Mobile):

Email:

Current employment

Name and address of employer:

Postcode:

Date started:

Date left:

Notice required:

Reason for leaving:

Salary:

Brief description of your duties and responsibilities:

Previous employment

Dates	Name and address of employer	Job title and nature of work	Reason for leaving

Qualifications

Qualification/or training	Subject	Grade (if applicable)	Date gained

References

Please give names and addresses of two referees. One of who should be your current or most recent employment.

Referee 1

Name:

Company:

Address:

Postcode:

Referee 2

Name:

Company:

Address:

Postcode:

Additional information

What activities outside work interest you?

Do you hold a clean driving Licence?

How many days sickness have you taken in the last 12 months?

Sickness:

Do you have a criminal record?

Supporting Statement

Use this section to explain why you applied for this job and to show how you feel you are suitable for this position. You may include any other information that you feel is relevant to this application such as your education, work or personal qualities.

Declaration

I declare that the information contained in this form is true and complete, as at the date given below. I realise that false information or failure to disclose information may result in disciplinary action taken against me.

Date:

Equal Opportunites Monitoring

We aim to practice equal opportunities and will select candidates solely on merit irrespective of age, race, sex, disability, sexual orientation, religion, etc. This section is to ensure that our equal opportunities policy is being carried out and to check that unfair discrimination is not taking place.

In order to monitor the effectiveness of our equal opportunities policy, we request all applicants to provide the information indicated below.

All the information will be treated in confidence and will be used solely for the purpose of monitoring and will not be passed on to selectors.

Please tick appropriate boxes.

Gender:

Male
Female

Date of birth:

Marital Status or Sexual orientation:

Married
Single
Other

(please state):

Disability:

Do you consider yourself disabled?

Are you registered disabled?

Dependants:

Do you have responsibility for dependants?

(Dependants – relates to children, elderly or other persons for whom you are the main carer).

Ethnic origin:

White
Black-African
Bangladeshi
Indian
Black-Caribbean
Pakistani
Chinese

BlackOther (please specify):

Other (please specify):

Please note that these categories were used by the 1991 census by the office of population Censuses and Surveys and are recommended by the Commission For Racial Equality.

They do not refer to place of birth, citizenship and foreign born persons.