Application Form1 Position2 Personal Details3 Education / Qualifications4 Interests5 Employment6 General Information7 SignatureAn applicants’ CV will only be accepted as an addition to the completed form. There will be an option to upload this at the end of the form.No applications will be considered without a completed and signed application.Position Applied ForFor OfficeAmblesideArnsideCarnforthGrange-Over-SandsKendalKeswickKirkby LonsdalePenrithWindermere.............................Marketing & SupportPersonal DetailsTitleFirst NameSurnameNational Insurance NumberAddressTelephone (Home)Telephone (Mobile)Current Full UK Driving Licence Yes NoDetails of endorsementsAre there any restrictions on you taking up employment in the UK? Yes NoIf yes, please provide detailsWill this be your only employment if successful? Yes NoIf no, please provide detailsAre there are any reasonable adjustments that may be required should you be invited to an interview? Yes NoIf yes, please provide detailsInterests / HobbiesPlease state any interests including sports, pastimes, hobbies and voluntary work:UntitledPublic duties undertaken /offices held(JP, local Councillor, etc):Education / QualificationsSchool/College/University AttendedListQualifications obtained or to be takenResult / Grade Please add more rows as required to add further qualifications.Add another place of education?YesNoSchool/College/University AttendedListQualifications obtained or to be takenResult / Grade Please add more rows as required to add further qualifications.Add another place of education?YesNoSchool/College/University AttendedListQualifications obtained or to be takenResult / Grade Please add more rows as required to add further qualifications.Add another place of education?YesNoSchool/College/University AttendedListQualifications obtained or to be takenResult / Grade Please add more rows as required to add further qualifications.Training(Details of any other short courses or in-company training or qualifications)ListDate FromDate ToDuration of CourseOrganising BodyCourse Title (including any qualifications obtained) Please add more rows as requiredPresent/Last EmploymentName of EmployerAddress of EmployerSalaryDate AppointedNotice RequiredLeaving Date (if applicable):Reason for Leaving (if applicable):Position HeldBrief Outline of Duties and Responsibilities:Most Recent Previous EmploymentPlease give details of your most recent previous employer, prior to the one above.Name of EmployerAddress of EmployerSalaryDate AppointedNotice RequiredLeaving Date (if applicable):Position HeldBrief Outline of Duties and Responsibilities:Previous EmploymentIn date order, please give details of other previous employment. Most recent first, with no gaps unaccounted for.Date FromDate ToEmployerPosition HeldSalaryReason for Leaving Please add more rows as requiredGeneral Information in Support of ApplicationPlease give details of past experience you have gained paying particular attention to how your experience, knowledge and personal qualities match the requirements of the person specification.UntitledRehabilitation of OffendersDo you have any convictions, cautions, reprimands or final warnings that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)YesNoRefereesYou are required to provide the names of two persons whom the company may obtain both character and work experience references. One of your references should be your present or last employer. If you choose not to give your present (or last) employer as a referee you should be able to provide a reason for this at interview. References will only be requested when a job offer has been accepted by you and never before.Reference 1NameOccupationCapacity in which knownAddressTelephoneEmailReference 2NameOccupationCapacity in which knownAddressTelephoneEmailDeclarationI declare that the information I have given on this application including details in this form, in my letter and in my CV (if applicable) is correct and factual. I understand that any false, misleading or inaccurate statement may be sufficient to cause disqualification, withdrawal of any offer of employment or, if employed, to dismiss. The wilful suppression of any material fact will be similarly penalised, except as provided in the Rehabilitation of Offenders Act 1974.I authorise Hackney & Leigh, upon me accepting an offer of employment, to obtain references to support my application and release them and referees from any liability caused by this information.Where an offer of employment is made, it is subject to our acceptance of the appropriate documentation demonstrating your right to live and work in the UK and us obtaining and accepting employment and/or character references that are satisfactory to us. If we are unable to secure appropriate legal documentation on your right to live and work in the U.K. and acceptable employment references or a reference is not, in our opinion, satisfactory, we reserve the right to withdraw our offer of employment, if employment has already commenced, to terminate the employment contract.I give my permission for this personal information to be stored and processed for the purpose of arriving at a selection decision. I also give permission for the information provided to be used to form the basis of personnel records should I be appointed and understand that information will be processed in accordance with the Data Protection Act.SignatureFull NamePlease tick to confirm you have read the declaration above Yes
