THE DEVELOPMENT CENTRE by HC121001102844

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									                 THE DEVELOPMENT CENTRE

                         SKILLSEEKERS
                       APPLICATION FORM
       Please complete ALL sections using a ballpoint pen and BLOCK LETTERS

DATA PROTECTION ACT 1986. The information you give may be put onto a
computer to assist with record keeping.


Age:                 16-18               18+
                                         
Title: Mr/Mrs/Ms/Miss: ___________     Surname:____________________

Forename(s): _______________________________________________

Address: ___________________________________________________

___________________________________________________________

_________________________            Postcode:   ____________________

Telephone No (day): ____________        (evening) ___________________

Mobile No: ____________________



Date of birth:    day  month  year

Please give your National Insurance Number:      



              The Development Centre, Pembrokeshire County Council,
                     London Road, Pembroke Dock. SA72 6TT
What subjects did you study at school? (Include any craft or practical subjects). If you
have an exam, state the type (GCSE, GNVQ, AS, A Levels) and if you know the
grades obtained.

Subject        Exam                Grade     Subject        Exam                Grade




When will you/did you leave full time education?        month  year
Name and address of last school/college attended __________________________

Type of training preferred and why

__________________________________________________________________

__________________________________________________________________

Give details of past employment or training if any.

Post                Employer/Training   From           To          Reason for
                    Provider                                       Leaving




School work experience

__________________________________________________________________

__________________________________________________________________

Leisure interests

___________________________________________________________________

___________________________________________________________________

Any other information which you consider important to this application

___________________________________________________________________
Health

Do you have any health problems that might affect the type of work you can do?

YES           NO     
If Yes, please give details

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________


Please give details of personal achievements (e.g. Driving Licence, Sport,
Eisteddfod)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Rehabilitation of Offenders Act 1974

Have you ever been convicted of a criminal offence or are legal proceedings
outstanding?

           YES             NO  
If Yes, nature of conviction, proceeding and date ___________________________

__________________________________________________________________

__________________________________________________________________

Equal Opportunities

Please help us by ticking the right box below to ensure equal opportunities are being
met:

WHITE                 INDIAN                     BLACK AFRICAN        
PAKISTANI             BLACK CARIBBEAN            BANGLADESHI          
BLACK OTHER           CHINESE                    OTHER                
Signed __________________________________             Date ____________________

NAME IN CAPITALS
Other Comments:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

________________________________________________________________________




           The Development Centre, Pembrokeshire County Council,
                  London Road, Pembroke Dock. SA72 6TT

								
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