Job Application Forms 3Job Application Forms 2

							Railway Housing
     Association




  Application for
  EMPLOYMENT
Private and Confidential

For the purposes of Data Protection please note that the personal information supplied by you on this form will only be used for
recruitment purposes and will not be disclosed to any third party.
The information given will form part of the confidential personal record of the successful candidate.
All application forms will be retained for a period of eight months.
Please do not submit CV’s as they will not be considered.
In the interest of economy, applications will not be acknowledged unless a stamped addressed envelope is enclosed with your
application. If you have not been contacted within four weeks of the closing date please assume that your application has been
unsuccessful.

 Post applied for:



 Personal Details

 Surname

 Forename(s)

 Home Address




                                                                  Post Code

 Home no.                                                         Mobile no.

 Work no.

 May we contact you at work?                YES/NO

 Do you have a current driving licence?     YES/NO

 If you are related to any member of the Board or the Senior Management Team please state his/her name below, detailing the
 relationship.




 Are there any restrictions on you taking up employment in the United Kingdom?         YES/NO
 (If yes, please provide details)




 References
 Please give details of two people we may approach for references, one of whom must be your current or most recent employer.


 Name                                                            Name

 Address                                                         Address




 Contact no.                                                     Contact no.

 Relationship                                                    Relationship

 May we contact prior to interview?         YES/NO               May we contact prior to interview?         YES/NO
 Equal Opportunities Monitoring Form

 Railway Housing Association is an equal opportunity employer. Working towards equality and valuing diversity, we welcome
 applications from all sections of the community.
 Our selection criteria and procedures are frequently reviewed to ensure that individuals are selected, promoted and treated
 on the basis of their relevant merits and abilities.
 We are committed to an ongoing programme of action to make our equal opportunities policy fully effective. To ensure that
 this policy is fully and fairly implemented and monitored, and for no other reason, would you please provide the following
 information:-
 Post applied for

 Name of Applicant

 Date of Birth                                                            Sex:    Male / Female

 Ethnic and National Origin
 a) White
         English                             Scottish                            Welsh                      Irish
    Any other White background, please specify


 b) Mixed
        White and Black Caribbean            White and Black African             White and Asian
    Any other Mixed background, please specify


 c) Asian, Asian British, Asian English, Asian Scottish or Asian Welsh
        Indian                               Pakastani                           Bangladeshi
    Any other Asian background, please specify


 d) Black, Black British, Black English, Black Scottish or Black Welsh
        Caribbean                             African
    Any other Black background, please specify


 e) Chinese, Chinese British, Chinese English, Chinese Scottish, Chinese Welsh or other Ethnic Group
        Chinese
    Any other background, please specify


 Disability
     Do you consider yourself to have a disability as defined under the Disability Discrimination Act 1995? as detailed below:
     ‘a physical or mental impairment which has a substantial and long term adverse effect on your ability to carry out
     normal day to day activities’
     YES / NO (if yes please give brief details)


     Do you have any specific requirements to enable you to attend an interview - access to premises, travelling
     arrangements, timing of the interview, type of interview, induction loop etc?
     YES / NO (if yes please give details)


     Do you have any specific requirements should you be appointed to the post? Employers have a duty to consider what
     reasonable adjustments could be made to working practices or premises to overcome the effects of a disability e.g.
     working hours, access to premises, special equipment etc.
     YES / NO (if yes, please give details)



 Signed:                                                          Date:

This information will not be circulated to the selection panel, but will form part of the personal confidential record of the
successful applicant.
Criminal Records

a) Do you have any criminal convictions except those ‘spent’ under the Rehabilitation of Offenders Act 1974?
   YES/NO (if yes, please give details)




b) Due to the nature of the post appointment will be subject to an Enhanced Criminal Records Bureau Disclosure.
   A copy of the Association’s Policy in respect of such disclosure’s is included in the Application Pack.

     Have you ever had a criminal conviction? YES/NO (if yes, please give details)




Declaration (please read the following statements carefully before signing this application form)

1.   I declare that the information on this application is correct and complete to the best of my knowledge and I understand
     that providing false information may lead to withdrawal of an offer of appointment or dismissal without notice if I have
     already been appointed.

2. I agree that should I be successful in this application I will, if required, apply to the Criminal Records Bureau for an
   enhanced disclosure. I understand that should I fail to do so, or should the disclosure not be to the satisfaction of the
   Association any offer of employment may be withdrawn or my employment terminated.

3.   I agree that the Association reserves the right to request a medical report (with my permission) and that any offer of
     employment may be subject to such a report.

4. I understand that the canvassing of employees or Board Members of the Association will result in disqualification of this
   application.


Signed:                                                          Date:

Please return the completed application form to:



                                                Railway Housing Association
                                                      Bank Top House
                                                      Garbutt Square
                                                      Neasham Road
                                                        Darlington
                                                         DL1 4DR

                                                   Telephone: 01325 482125
                                                      Fax: 01325 384641
Present or most recent employment

Name and address of employer



Job title

Date started                                                   Date left (if applicable)

Salary

Brief details of duties




Reason for leaving



Notice period required

Employment History
Please give details of your previous employment, most recent first.
Employer                             Job Title              Salary         Dates employed Reason for leaving




Please give reasons for any gaps in employment
Secondary/Further/Higher Education

  Schools/college/universities attended               Qualification type/level (GCSE, A Level, degree)   Grade




Short Courses

Please give details of any current, relevant short courses or training you have attended.
Subject                                               Qualification                              Date Attended




Professional Bodies

If you are a member of any professional bodies, please give details below.
Further Information

Please use this section to submit any additional information relevant to your application, making specific references to the
criteria detailed on the enclosed person specification - please continue on a separate sheet if necessary.
                                                                                                                        Printed by MTP 01325 463171




          Railway Housing Association
          Bank Top House, Garbutt Square, Neasham Road, Darlington DL1 4DR        Tel: 01325 482125 Fax: 01325 384641
Issue 3   Registered Social Landlord: A1855 Registered Charity: 216825   MEMBER OF THE HOUSING OMBUDSMAN SERVICE