Please complete this form in black ink or typescript. Continue on the back of this form or a separate sheet if necessary.
Position applied for:
Operations and Development Assistant
Personal Details
Surname (Block letters): Forename(s): Date of birth: Telephone number: Mobile number:
Address:
Email address:
Full Clean Driving Licence?
Yes / No
Do you have daily access to a car for business use?
Where did you see this post advertised?
FOR OFFICE USE ONLY INTERVIEW DATE CONFIRMED
TIME REFERENCES REQUESTED
REFERENCE RECEIVED
APPOINTMENT OFFERED STARTING SALARY
START DATE
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Yes / No
Previous employment (most recent position first) Employer & Post
From:
To:
Salary:
Brief outline of duties
Reason for leaving Employer & Post
Period of notice From:
To:
Salary:
From:
To:
Salary:
Brief outline of duties
Reason for leaving Employer & Post Brief outline of duties
Reason for leaving Continue on a separate sheet if necessary
Professional qualifications and training Dates
Organisation
Qualification
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Education In chronological order – most recent first
From
To
Qualifications (please state subject and
School/College/University
grade)
Do you have any special access requirements? YES / NO
If YES, please give brief details:
References Please give names, addresses and occupations of at least two persons to whom reference may be made. Please state your relationship with referees; at least one must be your present employer.
Name:
Name:
Relationship:
Relationship:
Email address:
Email address:
Address:
Address:
May we approach your present employer for a reference before interview? YES / NO Operations and Development Assistant Application Form, 2014 Page| 3
Statement in support of application – please use this space to state your reasons for applying for the post, relating your skill, experiences and personal qualities to the job requirements (continue on a separate sheet if required).
I declare that the statements made by me are true to the best of my knowledge.
Signature
Date
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Forms to be returned/emailed to: Claire Defty Operations Lead TIN Arts Limited Old School House Front Street Framwellgate Moor Durham DH1 5BL Tel: 0191 3840728 Email: claire@tinarts.co.uk Deadline for applications: 12.00 noon on Monday 22nd September 2014 Interviews will be held on Friday 26th September 2014 If you are successful in securing an interview, you will be notified by Tuesday 23rd September 2014.
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Equal Opportunities You do not have to give us the following information but we would be very grateful if you would answer the questions below. Any information provided may be used for monitoring and reporting. We will not use this information to assess your application. 1. Please mark the box that best represents you. White British Irish Asian or Asian British Asian Bangladeshi Asian Indian Asian Pakistani Any other Asian background Black or Black British Black African Black Caribbean Any other Black background Chinese Asian and White Black African and White Black Caribbean and White Chinese and White Any other background from more that one ethnic group Any other ethnic group (please give details) 2. Do you consider yourself to be disabled? Yes
No
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