APPLICATION FORM

Position Applied for? *

Please choose from the drop down list

Title *

(Mr, Mrs, Miss, Mx etc)

Last Name (inc. any previous surnames) *

First Names *

Address *

Address Line 1

City

State / Province / Region

Postal Code

National Insurance No: *

Telephone Number *

Email Address *

Education

Please give full particulars of All secondary level educational qualifications

Please give full particulars of All secondary level educational qualifications *

(Level attained, subject passed, Grade, Year)

Please specify any professional qualifications, membership obtained including dates awarded: *

(Name of Professional Body - Part NO. with Date and Result)

Additional qualifications, training and apprenticeships relevant to this post (with dates including any in progress) *

Employment

Present Post

Name of present employer *

Address of present employer? *

Job Title: *

Reason for Leaving: *

Date Appointed MM/YY *

Present Salary *

Notice Period *

Principal duties of present post: *

Please list all your work history

BEGINNING WITH THE MOST RECENT POSITION.

(if unemployed put N/A)

Employment History

1. Employer: *

Name and Address

Date (from MM/YY) *

Date (to MM/YY) *

Post held and Brief outline of duties *

Reason for leaving *

2. Employer: *

Name and Address

Date (from MM/YY) *

Date (to MM/YY) *

Reason for leaving *

Post held and Brief outline of duties *

3. Employer: *

Name and Address

Date (from MM/YY) *

Date (to MM/YY) *

Reason for leaving *

Post held and Brief outline of duties *

If you have any gaps in your employment please state why? *

Have you ever been dismissed from a place of employment? *

if Yes, please give details:

Job Related Experience

Applicants must indicate how their experience to date meets the requirements of the Job Description and fulfils the criteria contained in the Person Specification. *

Experience gained outside the workplace may be included.

Additional Information

Do you hold a current full driving licence? *

If yes what type?

Private
HGV

Do you have access to a motorcar? *

Do you have the right to work in the UK? *

(Note: The company will require proof of this right before an offer of employment can be confirmed – eg. Birth certificate and/or any other appropriate document required to confirm your right to work in the UK as required by the Asylum and Immigration Act 1996)

Medical History

Do you have a medical condition that may affect your performance in the job? *

If Yes please give details:

ACCESS NI

Have you ever been convicted of a criminal offence, which is not “spent” under the provisions of the Rehabilitation of Offenders (NI) Order 1978? (NB: note motor offences and road traffic offences are criminal offences.) *

(NB: note motor offences and road traffic offences are criminal offences.)

If Yes you must give details below:

Failure to disclose such information as detailed above could result in dismissal. Unprejudiced consideration will be given to candidates who declare criminal conviction(s) unless their offence(s) is/are manifestly incompatible with the post in question. The Towell Building Trust Ltd has a written policy on the recruitment of ex- offenders. This is available on request from Towell House. The Towell Building Trust Ltd has a written policy on the Storage and Handling of Disclosure information. This is available on request from Towell House. As a regulated facility Applicants should be aware an enhanced Access NI check is required for this post. Applicants should also be aware a trace on your Access NI check does not necessarily disbar from employment. Each case is assessed individually. ACCESS NI Code of Practice can be obtained at: https://www.nidirect.gov.uk/sites/default/files/publications/accessni-code-of-practice.pdf Or you can contact the following either by post or telephone: ACCESS NI PO Box 1085 Belfast BT5 9BD Phone: 0300 200 7888

Do you agree to an Access NI check? If your response is no we will be unable to process your application *

Is there a reason you cannot work in regulated activity? *

Do not enter N/A. Answer of yes or no is required.

References

Please give the names and addresses of two persons, not related to you, from whom references may be sought. One of these MUST be your present or a last employer who has knowledge of you in a work situation and is able to comment on your ability to carry out the particular tasks of the job which you have applied for. Candidates applying for their first job should give the name and address of their Head Teacher or a Lecturer

Reference 1

1. Reference Name *

Address *

Email *

Tel. No. *

Occupation *

Reference 2

2. Reference Name *

Address *

Email Address *

Tel. No. *

Occupation *

If you have not named your current employer (or if unemployed your previous employer) please state why: *

Please note that references will only be sought post interview if the panel is considering offering you an appointment.

How did you hear about this vacancy? *

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JobApplyNI
NIJobs
Other

If other please give Details?

Sign and Date

Sign *

Date *

Home / Application Form

Education

Employment

Present Post

Please list all your work history

BEGINNING WITH THE MOST RECENT POSITION.

(if unemployed put N/A)

Employment History

Job Related Experience

Additional Information

Medical History

ACCESS NI

References

Reference 1

Reference 2

Sign and Date

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