Application Form Contact Details Title * First Name * Surname * Address * City * County * Post code * Telephone * Mobile * Email Address * Position Position applied for * How did you hear about the position? * Are you applying for * Full-time positionPart-time positionDay workNight workBank Driving Do you hold a full UK or European Economic Area (EEA) driving licence? * YesNo If yes, has your driving licence been endorsed? * YesNo Do you have a vehicle you can use for business purposes if required? * YesNo If yes, please explain Full Employment History Please list below your complete and full employment history, explaining all employment gaps, starting with your most recent employer, working backwards to when you left full-time education (continue on a separate sheet if necessary). Please also attach a full CV (if possible). Full CV Employer 1 Company Name Reference Details * Address Phone Email * Job title and main duties * Position Salary Start Date End Date Notice period * Reason for leaving Employer 2 Company Name Reference Details * Address Phone Email * Job title and main duties * Position Salary Start Date End Date Notice period * Reason for leaving Employer 3 Company Name Reference Details * Address Phone Email * Job title and main duties * Position Salary Start Date End Date Notice period * Reason for leaving Employer 4 Company Name Reference Details * Address Phone Email * Job title and main duties * Position Salary Start Date End Date Notice period * Reason for leaving Education Secondary School (name and address) * Qualifications gained * Start Date * End Date * Further Education Further Education e.g. college / university * Qualifications gained * Start Date * End Date * Qualifications & Training Please give details of any professional qualifications gained Are you undertaking any course of study at present? * YesNo Character References Please provide details of two people who can be contacted for a reference if you have not provided a full 5 year work history. The referee must be able to comment on your suitability and character for the post you have applied for (e.g. fellow work colleague or course tutor). Relatives and/or Partners should not act as referees. Referees will not be contacted without your consent. Reference 1 Contact name Job title Address Telephone Email Address Relationship to you Number of years known Reference 2 Contact name Job title Address Telephone Email Address Relationship to you Number of years known Additional Skills Please use the space below to explain why you have applied for this vacancy. You should include details of your experience, skills and personal qualities that you can bring to this role. Please continue on a separate sheet if you need to (please put your name at the top of the sheet). You will need to refer to the enclosed job description and person specification when completing this section. Please submit a copy of your resume Eligibility to work in the UK: Do you have the right to work in the UK? * YesNo Please provide details of your visa and any restrictions in the space provided below (if applicable) * Other Employment To allow us to monitor your working hours and comply with current legislation, please complete the following section: If you are successfully appointed to the post applied for at Peak15, do you intend to continue with other employment? * YesNo Disclosure of criminal record information Due to the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders 1974 (Exceptions) Order 1975. This means that convictions that are ‘spent’ under the terms of the Rehabilitation of Offenders Act 1974 must be disclosed and will be taken into account in deciding whether to make an appointment. Any information will be completely confidential and will be considered only in relation to this application. Please read the above carefully and then answer the following questions: Have you ever been convicted of a criminal offence? * YesNo Have you ever received any official cautions, reprimands or warnings? * YesNo To your knowledge, are you currently the subject of any criminal proceedings or any police investigation? * YesNo Data Protection: The Peak 15 Recruitment Privacy Statement is available here or a copy can be requested from the Human Resources Department. Please sign below to confirm you have accessed the Peak 15 Recruitment Privacy Statement and you have read, understood and agree to all the terms stated. Signature of Applicant * Date * Declaration: I declare that the information given in this application is to the best of my knowledge, complete and correct. I accept that should any statement made by me in connection with this application be found to be false, incomplete or misleading then the application shall be void and consequently, Ashcroft may terminate any contract arising at any time. Because of the sensitive nature of the duties the postholder will be expected to undertake, I understand that the declaration will include details of any criminal convictions, cautions, reprimands and final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013) and any other information that may have a bearing on my suitability for the post. I also understand that the relevant level of DBS check will be sought in the event of a successful application. Signature of Applicant * Date *
