Application Form
Please refer to guidance notes when completing application form. Please make sure that you read the Home Office Circular. There are required fields in this form. Submit at the end.
1 Vacancy Details
Job(s) Applied For:
*
Ref No:
2 Present or most recent employment, voluntary work or role
Job Title:
*
Name of Employer:
*
Employer’s Address:
*
Postcode:
*
Hours worked:
Dates employed:
*
Notice period:
*
Current salary plus benefits:
Key duties:
3 Reason for wishing to leave or left:
Reason:
The Working Time Regulations place a maximum limit on weekly hours worked (48 hours). Will you continue in any other employment, should you be offered this appointment?:
*
Yes
No
4 Previous Employment
Starting with the most recent first, please give details of jobs held including part time and unpaid work. Do not include the details provided in Section 2 of the application form. Attach a separate sheet if necessary.
Name of employer:
Job title and main duties:
Reason for leaving and length of employment:
Name of employer:
Job title and main duties:
Reason for leaving and length of employment:
Name of employer:
Job title and main duties:
Reason for leaving and length of employment:
Attach extra details:
5 Education
Please give details of any educational, technical and/or professional qualifications. If you are currently studying please provide details of the qualifications you are studying for.
Examinations/qualifications taken or to be taken. Results and grades (include subjects)
6 Training
Course title:
Organising body:
Length of course:
Course title:
Length of course:
Organising body:
Course title:
Organising body:
Length of course:
7 Membership
Name of Organisation (1):
Type of membership:
Is membership current?:
Yes
No
Name of Organisation (2):
Type of membership:
Is membership current?:
Yes
No
8 Skills, Ablilities, Experience and Achievements
Please give details of your skills, abilities, achievements and experience (including outside interests) and use examples to demonstrate how you meet each of the criteria listed in the person specification. You may attach extra details if necessary.
Skills Details:
Attach extra details:
9 Personal Details
Surname:
*
Forename (s):
*
Title (select):
*
Mr
Mrs
Miss
Ms
Other
Other:
Date of Birth:
*
Address:
*
Post Code:
*
Is this a job share application:
*
Yes
No
Contact details
Home:
Work:
Mobile:
Email:
Preferred contact detail:
*
Home
Work
Mobile
Email
Are you eligible to work in the UK?:
*
Yes
No
Are you required to have a work permit to work in the UK?:
*
Yes
No
Convictions/Disqualifications
Please give details and dates of a) any convictions (including driving offences) and/or b) disqualifications from driving or performance of professional duties:
Canvassing
In order to ensure fairness and openness of our selection process please state whether you are related to, or in a close personal relationship with a Councillor or employee of Swindon Borough Council:
*
Yes
No
If yes, please give details:
Name:
Position in Council:
Relationship with yourself:
Please note that canvassing of Councillors or employees of Swindon Borough Council in relation to this application will disqualify any applicant. If evidence of this is discovered after appointment you may be dismissed without notice.
I declare that the information I have given in this application is correct and complete. I understand that any false statements or failure to disclose information requested on this form may result in my application being disqualified or may lead to my dismissal or disciplinary action if appointed.
Declaration:
*
Yes
No
Data Protection. All information on this form will be treated in strictest confidence and used to process your application for employment. If you are appointed, this application will form the basis of your personal file and information on this form may be held on computer. If your application is unsuccessful your details will be kept for a period of 1 year and will then be destroyed.
10 Equal Opportunities Monitoring Form
You are requested to complete this information to enable us to monitor the effectiveness of our Corporate Equalities Strategy. This information will be used solely for monitoring purposes, will be treated as confidential and will be separated from the application form on receipt and before selection procedures commence.
Please select applicable options
Are you?:
*
Male
Female
Please indicate your current age band:
*
Up to 19
20-29
30-39
40-49
50-59
60-69
Over 70
How would you describe your ethnic origin?
White:
British
Irish
Polish
Italian
Any other White background
Black or Black British:
Caribbean
African
Any other Black background
Mixed:
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed Background
Asian or Asian British:
Indian
Pakistani
Bangladeshi
Any other Asian background
Chinese or other Ethnic Group:
Chinese
Any other ethinic group
Do you consider yourself to have a disability?:
*
Yes
No
If yes, please tick the appropriate boxes:
Dyslexia
Deaf/Hearing Impaired
Wheelchair User/Mobility Impairment
Blind/Partially Sighted
Mental Health Difficulties
Unseen e.g. Diabetes
Where did you see this vacancy advertised?:
*
Local Newspaper
National Newspaper
Professional Journal
Job Centre
Internet
Other
If Internet state website/or state other:
Are you currently employed by Swindon Borough Council?:
*
Yes
No
If you wish, you may disclose information about yourself in this section about your:
Religion:
Sexual orientation:
11 Disability
We guarantee to interview disabled applicants who meet the essential requirements for the post.
Do you consider yourself to have a disability?:
*
Yes
No
Please state any particular assistance or facilities you may require in attending an interview:
12 References
Please give details of 3 referees who are able and willing to comment on your suitability for the job, one of whom must be your present or most recent employer. If you have just left full time education you should give details of your course tutor or teacher. References from friends or relatives are not acceptable.
Ref 1
Name:
*
Position/Occupation:
Address:
Telephone Number:
Fax Number:
Email:
*
Relationship to yourself:
May we contact referee prior to interview?:
*
Yes
No
Ref 2
Name:
*
Position/Occupation:
Address:
Telephone Number:
Fax Number:
Email:
*
Relationship to yourself:
May we contact referee prior to interview?:
*
Yes
No
Ref 3
Name:
*
Position/Occupation:
Address:
Telephone Number:
Fax Number:
Email:
*
Relationship to yourself:
May we contact referee prior to interview?:
*
Yes
No
13 Driving Qualifications
You should only complete this page when driving is required for the post. The person specification will confirm if driving is needed to carry out the duties for the post e.g. Refuse Driver. For other posts driving may not be an essential requirement to carry out the duties and alternative methods of transport could be used e.g. public transport, cycling, walking etc.
Do you hold a current driving licence?:
No
Provisional
Full
Please state categories of licence held:
Do you have any driving endorsements?:
Yes
No
Do you have regular access to a vehicle?:
Yes
No
Process Application
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