Job details

Position you are applying for?

—Please choose an option—CarerNurseTrainersCatering assistantHouse keeper/cleaner

Personal details

Surname

Forename(s)

Preferred name

National Insurance number

Address

Email address

Contact number

Are there any dates you cannot attend an interview?

Are there any adjustments that you may require should you attend an interview (eg. Communicator, escort/guide, papers in large print or Braille, translation facility etc.)

YesNo

If yes please state here

How much notice is required under your current contract of employment?

Have you applied for any other positions within EverGreen Academy Ltd?

YesNo

If so, when and what position?

Are you related to any board members or to any EverGreen Academy employees?

YesNo

If yes, who and what relationship?

Work permit

Do you require a work permit to work in the UK?

YesNo

If yes, what is the expiry date of your work permit?

Visa restrictions (if any)

Criminal convictions

Under the provisions of the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 1986, you are required to give details of any criminal conviction, including those which are spent. Failure to do so may render you liable to summary dismissal. You are required to answer the following question if the post for which you are applying involves working with young people under 18 years of age or is concerned with providing care for the elderly or disabled people.

Do you have any spent convictions?

YesNo

If yes, please give details

References

Please give details of two referees, one who can comment on your work and one personal referee. Relatives, friends or neighbours are not accepted as a referee. The first is normally your current or most recent employer or nearest equivalent. In some cases references will be taken up before second interview.

Career history

If not in employment please give a brief outline of your current situation

Most recent job

Company name

Job title

Type of business

Start date

End date

Reason for leaving

Finishing salary

Duties/responsibilities

Information in support of your application

Please use the person specification and job description and link these to past duties and experiences to indicate why you should be considered for this post. Make sure you include all relevant skills and knowledge which may have been gained through employment, community or voluntary work, or at home. Give specific examples where necessary.

Education, Professional Qualifications and training

Please list relevant qualifications and school name, eg. Name, Year of qualification, Subject, Grade and Level

Please list any relevant professional qualifications, eg. Name of professional qualification, Date of membership, Status

Please advise any other training courses, including in-house training and short courses relevant to the position

Any relevant community/voluntary experience

Equal opportunity monitoring

Evergreen Academy is committed to Equal Opportunities because it is convinced that all groups and individuals in society should receive fair treatment. Every person seeking employment will be considered on their merits and abilities to meet the specific needs of the job. In areas where we are under represented applicants from minority groups are positively treated. To assist towards this end, we would request that all applicants complete this form to assist us in our monitoring. The information on this form will be treated as confidential and used solely for monitoring purposes.

Upload your CV

If you wish you can upload your CV here in support of your application.

Declaration

I understand that the employment if offered will be subject to the information given in this application being complete and accurate and that any appointment will be subject to references acceptable to Evergreen Academy and possibly a medical examination.