Online Job Application Form

CONFIDENTIAL

Personal Information

Job Applied For

Family Name

Forenames

Address

Home Telephone

Mobile Telephone

Other Telephone Number

Email Address

References

First Referee (Current / Most recent employer)

Name

Address

Telephone Number

Email Address

Capacity in which known to you

Second Referee

Name

Address

Telephone Number

Email Address

Capacity in which known to you

Education

Please give details here of education and qualifications including any courses you are currently undertaking, any proposed courses, and any membership of any professional associations.

#	School/College (name/address)	Dates (from/to)	Qualifications
1
2
3
4
5

Please give details of other any other training undertaken.

Most Recent Employment

Job Title

Salary (include any benefits)

Name and Address of Employer

Reporting to

Start Date

Date of Leaving (if applicable)

Reason for leaving (if applicable)

Please give a brief description of duties and responsibilities

Previous Employment

#	Job Title	Employer (name/address)	Dates (from/to)	Brief description of main responsibilities
1
2
3
4
5

Supporting Statement

Please make full use of this section to give further information relevant to this application. You should include why you want to apply for this position, how your skills and experience match the requirements of the position, any details of other interests or voluntary work relevant to this position. Please continue on separate sheets if necessary.

Health

Please indicate the number of days taken as sick leave from work in the last FIVE years

Please give reasons for such absences

Have you had any hospital treatment in the last five years?

YesNo

May we ask your GP for a medical reference before offering employment?

YesNo

Do you consider yourself to have a disability under the terms of the Disability Discrimination Act?

YesNo

If you have a disability, and meet the minimum requirements for the post, do you wish to claim an interview?

YesNo

If you have a disability, please give details on a separate sheet of any facilities or arrangements that would help you through the recruitment process, or if your application is successful, facilities that would help you to perform the role.

Additional Information

Do you need a work permit to work in the UK?

YesNo

If yes, please give details

Do you agree to have a standard medical check?

YesNo

If you are offered this position, when could you start?

How did you hear of this vacancy?

This position is subject to a Criminal Records Bureau (CRB) check, do you give permission for this check?

YesNo

Do you have any unspent convictions within the terms of the Rehabilitation of Offenders Act?

YesNo

Please give details of any other office, remunerated post, profession, employment or voluntary work which you would wish to continue if your application to The Relationships Centre is successful. Include the average time spent on this activity and when it is normally undertaken.

If you were stuck on a desert island, what three things could you not live with out?

Equal Opportunities Policy - Monitoring of Job Applicants

The Relationships Centre accepts its responsibility as an equal opportunities employer and has adopted an equal opportunities policy. This is supported by a code of practice which includes provision for monitoring the effectiveness of our policy. Our aim is to ensure fair and equal treatment for all job applicants and to meet the relevant requirements of equal opportunities legislation.

You are therefore requested to fully complete the following questions in the Equal Opportunities Monitoring Form.

The following assurances are given in relation to the information you provide:

The monitoring form will be filed seperately from your application for employment
The data from this form is for statistical purposes only to help us monitor the effectiveness of our equal opportunities policy and will not be used for the purposes of shortlisting.
The information you provide will be treated in the strictest confidence.

If you have any queries in relation to the completion of this form, please do not hesitate to contact us at the address given above or by calling us on 01925 246910.

Equal Opportunities Monitoring Form

The Centre has an equal opportunities policy that is supported by a code of practice. In order to monitor the effectiveness of our policy in relation to recruitment we ask all applicants for our jobs to complete and return this monitoring form. We aim to ensure that all job applicants provide us with information.

The recruitment officer who has no involvement whatsoever in the selection process will receive your monitoring form. As soon as the relevant data has been extracted, your form will be shredded. The information you provide will not be used in any way in regard to your application. The ethnic origin classifications are those recommended by the commision for racial equality for the 2001 census.

Are you applying on a job share basis?

YesNo

Gender

MaleFemale

*How would you describe your ethnic origin? Please tick the category of your choice.

White:	Mixed:	Asian/Asian British:	Black/Black British:	Chinese or Other Ethnic Group:
British	White & Black Caribbean	Indian	Caribbean	Chinese
Irish	White & Black Affrican	Pakistani	African
	White & Asian	Bangladeshi
Other White Background (specify)	Other Mixed Background (specify)	Other Asian Background (specify)	Other Black Background (specify)	Other (specify)

* The categories used are those given by the commision for racial equality.

Declaration

Data Protection Act 1998: The Centre will process information provided on this form for the purpose of personnel administration, including pay and pensions. It will only be disclosed outside the Centre to organisations that are under contract to process data in these areas.

Declaration:

I declare that the information I have given is, to the best of my knowledge, true and correct and may be stored and used in accordance with The Relationships Centre's recruitment and selection procedures. I understand that canvassing or giving false information will disqualify my application or, if discovered after appointment, may be grounds for dismissal.

Please check this box to confirm that you have read and agree to the above declaration

The Centre is committed to being an Equal Opportunities employer. The Centre will not tolerate harassment or unfair discrimination on the grounds of sex, marital status, dependents, race, colour, nationality, ethnic or national origin, disability, age, religion or sexual orientation.

icons

The Relationships Centre (Cheshire) Limited is a wholly-owned subsidiary of The Relationships Centre. A charity registered in England and Wales. Charity Reg. No 1078372. Company Ref. No. 05173755. All profits from the subsidiary are donated back to the charity.

Website design by Anderson Baillie