Mind in the Vale of Glamorgan Application Form for Employment

Post applied for: *

Personal Information

First Name *

Last Name *

Email *

Phone *

Mobile

Full Address *

Post code

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Education

Please list your education history and qualifications, beginning with secondary education *

Dates / School, College, University / Qualifications & Grades

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Employment History

Please list all employment since finishing education, with no gaps between dates. If there were periods when you were not employed, please include these with a description of what you were doing (travelling, raising children, ill-health, seeking employment, caring) *

Dates / Employer & Address / Position / Salary

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Recent Vocational Training

Please list training or courses that you have attended during the last 5 years that are relevant to the post you are applying for *

Dates / Training / Course

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Supporting Statement

With reference to the job description, please tell us about your experience, qualities, knowledge, abilities and why you are suitable to meet the requirements of this post. *

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Licences & Permits

Do you hold a current full driving licence? *

Yes
No

Are you required to have a work permit? *

Yes
No

Do you hold a valid work permit? *

Yes
No

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

Yes
No

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Criminal Record

All Bath Mind employees are subject to a criminal records check by the Disclosure and Barring Service (DBS) before an appointment is confirmed. This will include details of cautions and reprimands as well as convictions.

Applicants with criminal records will be treated according to their merits and any special criteria of the post (ie: working with vulnerable adults) that debars some in this category.

Having a criminal record does not in itself necessarily prevent a person from being appointed to any post.

Have you been convicted of a criminal offence (spent convictions as defined by the Rehabilitation of Offenders Act 1974 being specifically excluded? Please note: This information will be confirmed with the Disclosure and Barring Service *

Yes
No

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Absence Record

Disregarding annual leave and statutory holidays, please state how many days you have taken off work for any reason (including sickness absence) during the last 2 years. *

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Reference 1

References- Please give names and details of two referees. These should not include relatives or personal friends. You must give the name of your line manager in your present or most recent employment as one refereeor if you are a college or university leaver your Departmental Head or Tutor. Contracts of employments will only be offered upon receipt of satisfactory references. Name of referee: *

Job Title: *

Organisation: *

Telephone: *

Email: *

Address: *

Post code: *

In what capacity does this referee know you? *

Reference 2

Name: *

Job Title: *

Organisation: *

Telephone: *

Email: *

Address: *

Post code: *

In what capacity does this referee know you?

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Declarations

Any Current Safeguarding issues /concerns? *

Yes
No

Are you related to a manager or owner of any business that trades with Mind in the Vale of Glamorgan? *

Yes
No

Are you related to a Mind in the Vale of Glamorgan trustee or employee? *

Yes
No

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Declaration *

I declare that the information given on this form is, to the best of my knowledge, true and complete and agree that it should form part of the basis of my engagement. Any false statement may be sufficient cause for rejection or, if employed, dismissal without notice.

Personal Information

Education

Employment History

Recent Vocational Training

Supporting Statement

Licences & Permits

Criminal Record

Absence Record

Reference 1

Reference 1

Reference 2

Declarations

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