Formby Deanery - Archdiocese of Liverpool
(A copy of this form and other relevant documents are available at www.youthminister.co.uk)
1 Family name: Address:
Title: Mr Mrs Ms Miss (Please circle)
Age if under18
2 How did you first hear about this job?
3 Do you hold a full UK driving license? Do you have access to a vehicle?
Yes No Yes No
Do you have any penalty points on your
licens? Please give details including how many.
4 Please give details of schools, colleges, universities etc, with qualifications gained:
(Most recent first) School or Institution Qualifications gained
5 Please give your present employment details (if in employment):
Name of employer:
Length of time employed here:
Salary or pay scale:
Description of duties and responsibilities:
Please list your previous employers, beginning with the most recent:
Employer’s name Address Position held Date Date Brief
and description of joined left Description of
Please give any other relevant information, for example: particular interests or skills; a brief
7 description of your personal qualities; any special training you have undertaken; membership of
any professional bodies: Continue on separate sheet if necessary.
Please describe all previous experience of work which has required you to work with or alongside
8 young people: Continue on separate sheet if necessary.
Describe briefly why you think that you would be an ideal candidate for this position:
Because of the nature of the work for which you are applying, this post is exempt from the
10 provision of the Rehabilitation of Offenders Act, 1974 Exceptions/Amendments S1 1986 N.
1249. You are not entitled to withhold information about convictions which for other purposes
are ‘spent’ under the provisions of the Act, and in the event of appointment, any failure to
disclose such convictions could result in the withdrawal of approval to work in an environment
where children and/or young people are present.
Have you ever been convicted of a criminal offence, or are you at present subject to
Yes No (Please tick. ).
If Yes, the nature of the offence:
N.B.1 The disclosure of an offence may be no bar to your appointment.
N.B.2 Due to the nature of the post, enhanced clearance through Criminal Record Bureau (CRB)
procedures will be required.
11 Please give the names and addresses of two people who know you well and who have agreed to
supply references for you. At least one of the referees should be able to speak directly of your
present or previous work with young people.
First reference Second reference
Tel no. Tel no.
Relationship to you Relationship to you
12 If appointed, when could you start work?
If in employment at present, how much notice
are you required to give to your employer?
13 I certify that the information which I have given in these pages is, to the best of my knowledge
and belief, correct.
Please return your completed application form to:
Deanery Youth Ministry Management Committee
The Presbytery, 18 School Lane, Formby, Liverpool. L37 3LW.