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									          application for employment
This information will be treated as confidential and will not
                                                                              Please return completed form to:
be disclosed without your permission. When completing
                                                                                   Rachel.miller@bristol.ac.uk
this form please use type or black ink for the purposes of
photocopying.


We are required under the Data Protection Act 1999 to inform you that some data you have supplied will be held on
computer or paper-based files.


NB: sending a CV instead of completing any section of this form is unacceptable.


position applied for:


closing date:                                                     dates unavailable for interview:


1. personal details

first name:                                                       family name:

address:


home tel:                                                         work tel:

mobile:                                                           email:

Please indicate which number we may use to contact you:

2. eligibility

Under the Asylum and Immigration Act 1996 we are obliged to ask you for proof of entitlement to work in the UK.

Do you need a work permit to work in the UK?                      Yes                          No




                tel: 0117 954 5800 | web: www.ubu.org.uk | charity: #1139656 | company: #6977417          1
3. present or most recent employer

name and address of employer:

position held:

date started:                           until:                            notice required:

brief description of duties/responsibilities:



reason for leaving:


4. previous employment

Please provide details of your employment history, either paid or unpaid, starting with your most recent
employment.

         Job title/name and address of employer/duties                       from                  to




        tel: 0117 954 5800 | web: www.ubu.org.uk | charity: #1139656 | company: #6977417           2
5. education, qualifications and training

Starting with the most recent, please list relevant details since age 16.

      educational establishment                           qualification received                   dates




6. supporting statement

Please show how your experience, skills and knowledge meet the criteria as set out in the Person Specification,
providing demonstrable examples where possible. You may prefer to submit this on a separate sheet of paper,
clearly named.




        tel: 0117 954 5800 | web: www.ubu.org.uk | charity: #1139656 | company: #6977417           3
7. disability

Please indicate if you are registered disabled or have a disability of which we should be aware.




8. rehabilitation of offenders act 1974

(Under the Rehabilitation of Offenders Act 1974, spent convictions need not be declared)

Have you ever been convicted of a criminal offence?          Yes             No         If yes please give details:




9. health record
Do you know of any health issues that would stop you from carrying out the duties required by this post?




10. other

Are you related to or do you have a personal relationship with any University of                Yes            No
Bristol Students’ Union employee?




11. referees

Please give the name of two referees, one being your current/most recent employer:

name:                                                      name:

job title:                                                 job title:

organisation:                                              organisation:

address:                                                   address:

telephone:                                                 telephone:

I confirm to the best of my knowledge the information on this form is true and correct.

Signature:                                                 Date:




         tel: 0117 954 5800 | web: www.ubu.org.uk | charity: #1139656 | company: #6977417              4

								
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