Hillingdon Refugee Support Group | Job Application Form

Job Application Form

Any information given on this form is confidential and covered by the Data Protection Act 1998

Thank you for completing this application.
Southlands Arts Centre 75 The Green, West Drayton Middlesex, UB7 7PW
Please note that CV’s will not be accepted for this post.

Step1

Step2

PERSONAL DETAILS

Title*

Surname*

Forenames*

Addresss*

Your E-mail address*

Telephone Number (Home)

Telephone number (Business)

Mobile number

National Insurance No.*

WORKING IN THE UK

Are you eligible to work in the UK/EEA?*

YES

Do you need a work permit to work in the UK?*

YES

Do you require further leave to remain?*

YES

If ‘no’ please give details of your visa or residence permit, including any expiry dates/work
restrictions:

EDUCATION & PROFESSIONAL QUALIFICATIONS (Most recent first) (ORIGINAL DOCUMENTATION AS PROOF OF QUALIFICATION WILL BE REQUIRED AT INTERVIEW)

School, College, University

Date Attended

Examinations taken

Result

PRESENT POST

Title of post

Salary

Name & address of employer

Business of employer:

Date commenced

Date ended (If applicable)

Please outline your responsibilities, to whom you are responsible and staff responsible to you (if applicable):

Reason for leaving or wishing to leave:

Period of notice required to terminate present employment:

PREVIOUS EMPLOYMENT (in chronological order, include periods of non employment)

Name and address of employer

Position held

Date From

Date To

Reason for leaving

Final salary/grade

REFEREES (Please provide referees for a minimum 5 year work history.)

Name of 1st Referee*

Organisation

Full address of referee:*

Position Held

Email address

Contact telephone number*

Name of 2nd Referee*

Organisation

Full address of referee:*

Position held

Email address

Contact telephone number*

RELEVANT EXPERIENCE

After reading the Job Description and Person Specification carefully, please describe here how your knowledge, experience and skills match those required for this post and listed in the person specification.
It is important that you provide evidence of your achievements by giving examples to support your application. You may wish to use the headings in the person specification in order to set the information out. Please read the notes included with this form before you complete this section.*

Please describe in no more than 500 words why you consider you are the best candidate for this position*

OTHER INFORMATION

What activities outside work interest you? (State any positions held you consider relevant e.g. secretary of local youth group)

Do you hold a current clean driving licence?*

YES

Do you own a car?*

YES

Are you related to any member or employee of HILLINGDON REFUGEE SUPPORT GROUP?*

YES

If yes, please provide name(s) and state relationship:

HEALTH

Please state the number of days sickness absence in the last 2 years:

DISABILITY DISCRIMINATION ACT 1995

Are there any adjustments which you think we could make to overcome a disability in relation to the essential requirements of this job?*

YES

If Yes, please provide further details

REHABILITATION OF OFFENDERS ACT 1974

Please note: This post is regarded as exempt under the Rehabilitation of Offenders Act 1974.
You are therefore required to declare here whether or not you have any criminal convictions even if they would otherwise be regarded as spent.
If you do not have any convictions, please write NONE.

Please declare any unspent convictions (or all convictions if the post is exempt) below and tick this box if doing so*

Unspent Convictions

REHABILITATION OF OFFENDERS ACT 1974

Because the job that you are applying for involves working with or has access to children or vulnerable adults or their records, we will require an enhanced Disclosure from the Criminal Records Bureau and need to have information from you regarding any previous, existing or pending convictions or cautions.
The advert and/or job description will state that the job is exempt from the Rehabilitation of Offenders Act. If you are applying for such a job, you are not entitled to withhold information even if you have convictions, which would normally be considered ‘spent’.
Please answer Q1 and Q2.

1. Have you ever been cautioned or convicted of a criminal offence?*

YES

2. Have you ever been disqualified from working with children or vulnerable adults?*

YES

You will be asked to provide details to the panel if selected for interview.
If you do not disclose any criminal convictions or caution, including those ‘spent’, it could result in withdrawal of the job offer, dismissal pr disciplinary action by the organisation.
Possession of a conviction or caution will not necessarily mean that you will not be appointed, each case is considered on its merits.
I will declare to the organisation, if appointed, my intention to continue to work for another employer or on a self employed bases (under the Working Time Directive)

DECLARATION

I hereby declare to the best of my knowledge the information given on this form is true and correct and can be treated as part of any subsequent Contract of Employment.

Dated*

NOTE:
Failure to disclose relevant details or a deliberate attempt to falsify information may lead to dismissal. Any false statement within this application regarding qualification or experience will result in disqualification.

Recruitment Monitoring Form (Confidential)

Hillingdon Refugee Support Group is committed to Equal Opportunities in Employment.
In order to ensure the effectiveness of this policy, all applicants are asked to provide the following information.
Any information given will be treated in the strictest confidence, and will be used solely for the purpose of monitoring.

THIS QUESTIONNAIRE WILL BE SEPARATED FROM THE REST OF THE APPLICATION FORM IMMEDIATELY ON RECEIPT BEFORE ANY CONSIDERATION OF CANDIDATES OCCURS

Post Title

Gender

Male

Female

Age*

18-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65+

ETHNIC ORIGIN
I would describe my ethnic origin as:

White (English)

White (Irish)

White (Gypsy) or Irish Traveller

White (Scottish)

White (Welsh)

Any other White background

Asian (Indian)

Asian (Pakistani)

Asian (Bangladeshi)

Asian (Chinese)

Any other Asian background

Black (African)

Black (Caribbean)

Any other Black, African, Caribbean background

Mixed (White and Black Caribbean)

Mixed (White and Black African)

Mixed (White and Asian)

Other mixed ethnic background

Other ethnic background (Arab)

Any other ethnic background

RELIGION OR BELIEF ; Please indicate your religion or belief if appropriate:

No religion (Atheism)

Christianity

Buddhism

Hinduism

Islam

Judaism

Sikhism

Other

I do not wish to disclose my religion

DO YOU CONSIDER YOURSELF TO HAVE A DISABILITY?

YES

When answering this question please note that under the Disability Discrimination Act 1995, a disability is defined as a “mental or physical “ impairment which has a substantive and long term adverse effect upon your ability to carry out normal day to day activities.

Please indicate which term is descriptive of your disability:

Dyslexia

Sight impediment/blind

Hearing impediment/deaf

Wheelchair user

Other mobility issues

Mental Health Condition

Disability not listed above

Please list any reasonable adjustments you think you may require:

Thank you for completing this application.

For further information please email:

applications@hrsg.org.uk

Data Protection Act 1998

The use of information provided on this form will comply with the requirements of the above Act. It may be processed by computer and is required for operational, managerial information and associated purposes relevant to the maintenance of the Hillingdon Refugee Support Group systems. Such data may also be used to produce depersonalised statistics.FAO

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Job Application Form

Job Application Form

Any information given on this form is confidential and covered by the Data Protection Act 1998

PERSONAL DETAILS

WORKING IN THE UK

EDUCATION & PROFESSIONAL QUALIFICATIONS (Most recent first) (ORIGINAL DOCUMENTATION AS PROOF OF QUALIFICATION WILL BE REQUIRED AT INTERVIEW)

PRESENT POST

PREVIOUS EMPLOYMENT (in chronological order, include periods of non employment)

REFEREES (Please provide referees for a minimum 5 year work history.)

RELEVANT EXPERIENCE

OTHER INFORMATION

HEALTH

DISABILITY DISCRIMINATION ACT 1995

DECLARATION

Recruitment Monitoring Form (Confidential)

THIS QUESTIONNAIRE WILL BE SEPARATED FROM THE REST OF THE APPLICATION FORM IMMEDIATELY ON RECEIPT BEFORE ANY CONSIDERATION OF CANDIDATES OCCURS

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