Application Form

JOB APPLICATION FORM

PLEASE COMPLETE THIS FORM USING BLOCK CAPITALS

Application for:

Job Title:

Part A: PERSONAL DETAILS

Full Name:

Title:

Address:

Postcode:

Telephone No:

Date of Birth:

National Insurance Number:

Part B: PRESENT OR MOST RECENT EMPLOYMENT

Name and address of employer:

Postcode:

Post held (job title):

Basic salary pa:

Date started:

until:

Notice Required:

Brief description of duties:

Part C: REFERENCES

Please give names and addresses of two people who can verify your employment record and give information about your suitability

for this post. One should be your present or most recent employer.

Name:

Job Title:

Address:

Telephone No:

Name:

Job Title:

Address:

Telephone No:

Part D: PREVIOUS EMPLOYMENT

From:

To:

Employers Name and Address:

Job Title:

Part E: EDUCATION AND QUALIFICATIONS

Please give brief details of courses attended and examination results:

From:

To:

Examination results (subject, grade, level):

Academic/professional:

From:

To:

Examination results:

Other training courses or qualifications:

From:

To:

Brief Details:

Part F: RELEVANT SKILLS AND ABILITIES

Please support your application with a statement in which you explain how you meet the requirements of the post as described

in the job description. You may also wish to set out how you would draw on your experience and achievements if appointed

to the post and why you are interested in working with us. Please include details of any relevant voluntary or unpaid work.

Part G: MONITORING - EQUALITY AND DIVERSITY

Schoolfriend has a commitment to ensure that all applicants are treated fairly and are appointed solely on their ability for the

post irrespective of race, sex, disability, sexuality or age. All stages of the recruitment process are monitored to check unfair

discrimination is not taking place. Please complete the following by ticking the relevant boxes as they apply to you.

I would describe my race or ethnic origin as:

Asian Bangladesh

Asian Pakistani

Black Caribbean

Greek or Greek Cypriot

White Irish

Asian Indian

Asian Chinese

Black African

Turkish or Turkish Cypriot

White UK

White other: Please specify

Black other: Please specify

Other Asian: Please specify

My Gender is:

Female

Male

I am aged between 16 and 65 years

Do you consider yourself to have a disability?

YES

Where did you see this position advertised?

Are you a car driver?

YES

Part H: DISCLOSURE OF CRIMINAL BACKGROUND, POSTS THAT INVOLVE ACCESS TO CHILDREN

The Rehabilitation of Offenders Act 1974 (exceptions and amendments) Order 1986 does not apply to posts where there is access

to children. This means that applicants for employment, which involves working with children and young people, must disclose

all their previous criminal convictions, including 'spent' convictions, bindover orders and cautions.

All disclosures of criminal background are strictly confidential. Checks are made only in connection with your application

for employment with children and for no other purpose.

Disclosure of a criminal background will not necessarily debar you from employment- this will depend upon the nature

of the offence(s), frequency and when they occurred.

All successful applicants will need to undergo an enhanced Criminal Records Bureau check.

Have you ever been convicted of a criminal offence?

YES

Part I: DECLARATION

Please complete the following declaration and sign in the appropriate place below. If this declaration is not completed

and signed with copies of relevant documentation your application will not be considered.

Providing false information or knowingly omitting any relevant fact about your eligibility for employment will result in your name

being withdrawn from the list of candidates. If such a discovery is made after you have been appointed, then you will be liable to

be summarily dismissed. If appointed you will be required to provide an original copy of your birth certificate or passport and if

required for the post, proof of professional qualifications.

I herby certify that all the information given by me on this form is correct to the best of my knowledge, that I have answered

all questions accurately and fully and that I possess all of the qualifications, which I claim to hold.

I do/do not* require a work permit to take up employment in the United Kingdom.

Signature:

Date:

HEALTH DECLARATION

Please answer the following questions. Answering yes will not necessarily exclude you from being offered a job with us however,

if it is found that you did not answer honestly Schoolfriend reserves the right to terminate your contract.

Any person applying for the post of Play Leader, Assistant Area Manager or Area Manager will also be required to complete a

medical consent form from Ofsted.

1. Do you suffer from any medical conditions which significantly affect any of the following:

Sight

Walking

Bending

Hearing

Climbing Stairs

Lifting

2. Are you currently taking any medication or having treatment from a doctor, hospital or any other medical practitioner?

YES

If Yes, please give brief details:

3. Have you suffered from any of the following:

Depression, anxiety or stress related illness?

Back, Neck or problems with joints, arms or legs?

Blackouts, fits, epilepsy or faints?

Alcohol or drug dependency or misuse?

Diabetes?

Do you smoke?

Breathing difficulties, including Asthma?

*Do you drink alcohol, if YES how much per week?

*How much alcohol per week?

I declare that to the best of my knowledge the answers given to the questions above are full and correct.

Signature:

Date:

All Schoolfriend Clubs undergo Ofsted Registration. Staff are CRB checked.
Schoolfriend etc is a registered charity, No 1112772.

4 Daleham Mews, London NW3 5DB
t 0870 442 2287 f 0870 442 2286 e office@schoolfriendetc.org www.schoolfriendetc.org