Job Applied For

Location

Where did you see this post advertised? Where did you see this post advertised?WMWA WebsiteCharity JobsWomen’s AidIndeedTwitterFacebookHoopleWord of mouthReedOther*

If other please give details

Name

Address

Phone number

Mobile number

Email address

Do you have a National Insurance No? Do you have a National Insurance No?YesNo

If you are not a member of the European Community, do you require a work permit to work in the UK? If you are not a member of the European Community, do you require a work permit to work in the UK?YesNo

Do you require a visa to work in the UK? Do you require a visa to work in the UK?YesNo

If required, do you hold a valid visa? If required, do you hold a valid visa?YesNo

If held when does your visa expire?

Please state the type of visa held

Are you related to anyone currently working or volunteering for WMWA? Are you related to anyone currently working or volunteering for WMWA?Yes*No

*If Yes please give details

Do you hold a full current driving licence & have daily access to a vehicle for business? Applies to posts requiring driving licence and access to vehicle. Do you hold a full current driving licence & have daily access to a vehicle for business? Applies to posts requiring driving licence and access to vehicle.YesNo

Have you experienced domestic abuse within the last 12 months? Have you experienced domestic abuse within the last 12 months?YesNo

Are you currently experiencing domestic abuse? Are you currently experiencing domestic abuse?YesNo

Have you been convicted of an offence, which is not spent, as defined in the above Act? Have you been convicted of an offence, which is not spent, as defined in the above Act?Yes*No

*If yes, please start a new line for each conviction and include: date(s), offence(s) and sentence(s) passed:

Children’s barred list Children’s barred list I confirm that I am not listed on the children’s barred list

Adult's barred list Adult's barred list I confirm that I am not listed on the adult's barred list

Past convictions, cautions, bind-overs and pending cases Past convictions, cautions, bind-overs and pending cases I declare that I have no past convictions, cautions or bind-overs and no pending cases affecting why I might be considered unsuitable to work with children/vulnerable adults

Name

Job Title

Employer Name & Address:

Telephone Number

Email Address

Relationship of referee to you

Name

Job Title

Employer Name & Address:

Telephone Number

Email Address

Relationship of referee to you

Academic Qualifications (degrees, A-levels, GCSEs) Please start a new line for each qualification and include: where and when gained and grade starting with the most recent. Presentation of original certificates will be required on appointment.

Other Training. Please give details of any other relevant training received, skills or courses you have undertaken

Name and address

Date employed From

Date employed To

Job title

Brief description of duties

Reason for leaving

Annual salary

Period of notice

Work History (Paid or voluntary) Please start a new line for each role and include: Employers Name & Address, Job Title, Reason for Leaving, Dates from (month/year) to (month/year)

Please give reasons for any gaps in your work history

How your experience and skills are able to meet the requirements

Please read WMWA mission and vision statement before answering this section

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