Job Application SW Oxon Generic MH

							                                                                           The Pathway Building
                                                                           Dunnock Way
                                                                           Blackbird Leys
                                                                           Oxford, OX4 3EX
                                                                           Tel. 01865 711267
                                                                           Fax 01865 395 444
                                                                           Email: enquiries@connectionfs.org
                                                                           Web. www.connectionfs.org

                                  JOB APPLICATION - CONFIDENTIAL
                              (Please complete all four pages - C.V.s are not sufficient)

                                   SUPPORT WORKER – Oxfordshire

          Please indicate preference: Generic              Mental Health          Full-time   Part- time

                  RETURN BY: 10 am 28th September 2012            INTERVIEWS: 4th & 5th October 2012

PERSONAL DETAILS

SURNAME:
FIRST NAME(S):
ADDRESS:
                                                                                 CONTACT INFORMATION
                                                                                 HOME:
                                                                                 WORK:
                                                                                 MOBILE:
                                                                                 EMAIL:


QUALIFICATIONS
What formal Educational Vocational/Professional qualifications and training do you have?

      DATES                                           DETAILS (including name(s) of institutions)




PRESENT OR MOST RECENT EMPLOYMENT
EMPLOYER’S NAME:                                                      NATURE OF BUSINESS:

POSITION HELD:                                                        FROM:
                                                                      TO:
SALARY:                                                               FULL/PART TIME

REASON FOR LEAVING:                                                   PERIOD OF NOTICE:

BRIEF DESCRIPTION OF DUTIES:
EMPLOYMENT HISTORY

Starting with the job immediately prior to your current one please list all periods of paid employment, including any
self-employment.

                                                    POSITION
                        EMPLOYER’S                 HELD - HOURS                                          REASON FOR
FROM        TO       NAME AND LOCATION              WORKED                        DUTIES                  LEAVING




              PLEASE CONTINUE ON A SEPARATE SHEET IF THERE IS INSUFFICIENT SPACE



VOLUNTARY WORK / OTHER ACTIVITIES

Please give details of any Voluntary Work, Training etc. undertaken by you which you feel may be relevant to this post
LEGAL REQUIREMENTS

THIS POST IS EXEMPT FROM Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Exceptions
Order 1975. Please give details of any convictions. Disclosure of past offences will not necessarily prejudice your
application.




WORKING WITH DIVERSITY / EQUAL OPPORTUNITIES

Connection is committed to working with Diversity and implementing Equal Opportunities in all its work. Please detail
how you think this would be relevant to your work, using the space below. You may find it helpful to relate this to item
3 of Knowledge and Understanding on the Person Specification.




REFEREES
Please give the names and addresses of two business references, one of whom should be your present or most recent
employer, state their position and their relationship/connection to yourself.

NAME .....................................................................            NAME .................................................................................

ADDRESS ...............................................................               ADDRESS ...........................................................................

...................................................................................   ...............................................................................................

...................................................................................   ...............................................................................................

POSITION ...............................................................              POSITION ...........................................................................

RELATIONSHIP .....................................................                    RELATIONSHIP .................................................................

TELEPHONE NO. .................................................. TELEPHONE NO. ..............................................................
Please note that we will not approach your referees without your permission but we will take up references before
making an appointment.
PRESENT APPLICATION
Please state why you are applying for this post and what you feel you can bring to the job and to the organisation.
Please ensure your answer addresses the points detailed in the person specification marked with an A as these will be
used to shortlist applicants for interview. Please pay particular attention to the “Experience” section of the Person
Specification – tell us what relevant transferable experience you have.




                     PLEASE CONTINUE ON A SEPARATE SHEET IF THERE IS INSUFFICIENT SPACE

I CONFIRM THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND
ACCURATE
 (Please note - if any particulars given by you in this application are found to be false or you wilfully omit or suppress
any materials facts, you may be liable to dismissal. By signing this, you are accepting that dismissal in such
circumstances would be fair and reasonable.)
NOTE: For positions where a CRB Disclosure is required, in the event of a successful application, you will be required
to apply for a Disclosure.
................................................................................................................ .............................................................
SIGNED - APPLICANT   DATE