Market Deeping Town Council
Town Hall
Market Place
Market Deeping
PE6 8EA
Tel:01778 343170
email: [email protected]
web: http://parishes.lincolnshire.gov.uk/marketdeeping/
Clerk: Mrs Julie Bourne
Private and Confidential
APPLICATION FOR EMPLOYMENT
POST APPLIED FOR:
Please answer all questions in black ink or type and return to the address quoted at the top of this
application form on or before the closing date.
In order that the application may be given full and fair consideration applicants are urged to ensure that
all sections of this form are completed with information relevant to the post applied for.
1. PERSONAL DETAILS
TITLE: MR / MRS / MISS / MS / OTHER _______________
SURNAME: ____________________ FIRST NAMES: _______________________
ADDRESS:________________________________________________________________________
_____________________________________________________
POST CODE: ____________
TEL: HOME ______________________ MOBILE: __________________________
Do you require a work permit?
YES / NO
2. SECONDARY EDUCATION
School, Colleges etc Dates (from/to)
Exams if taken – subjects with grades
3. FURTHER AND HIGHER EDUCATION
University,
Dates (from/to)
Qualification (with main subjects and
Polytechnic,
grades)
College
4. MEMBERSHIP OF PROFESSIONAL BODY, OTHER TRAINING COURSES
Dates
Body/Organisation
Details
5. PREVIOUS EMPLOYMENT (first post held last. Please continue on an additional sheet if
necessary).
Employer (with
Dates (From
Salary
Job Title with Main Duties Reason for
address)
and to)
leaving
6. PRESENT EMPLOYER (or last if unemployed)
Employer (with
From/To
Job Title and Department
address)
Salary
Notice Period
7. PLEASE GIVE DETAILS OF POST HELD AT PRESENT
Other employment: Please indicate if you have any other paid employment that you would wish to
continue if this application is successful.
8. PLEASE DESCRIBE IN MORE DETAIL RELEVANT EXPERIENCE, SKILLS ETC., GIVING
REASONS FOR APPLYING FOR THIS POST (Please continue on additional sheets if necessary)
9. PLEASE INDICATE YOUR OUTSIDE INTERESTS, HOBBIES ETC., INCLUDING MEMBERSHIP
OF ANY ORGANISATION OR UNPAID WORK.
10. HAVE YOU A CURRENT, CLEAN DRIVING LICENCE?
YES / NO
11. REFERENCES
Please name two referees, who should relate to your past employment (or school if you are a school
leaver) including your present employer if relevant.
Please do not forward original testimonials unless we ask for them.
Name
Name
Job Title
Job Title
Organisation
Organisation
Address
Address
If you are shortlisted, may we approach for a
reference before interview? YES/NO
If you are shortlisted, may we approach for a
reference before interview?
YES/NO
12. Please give details of any conviction, including date of conviction and sentence imposed.
NB.
(i) Road Traffic offences within the last five years should be included.
(ii) Convictions which are spent under the Rehabiliation of Offenders Act 1974 need not be
disclosed.
(iii) For posts within the purview of the Rehabilitation of Offenders (Exceptions) Order,
1985, convictions which would otherwise be spent must be stated.
13. Are you to your knowledge related to any Member of Market Deeping Town Council (Give
details as necessary)
Please note:
1. Deliberate omission or falsification of information could lead to disqualification of your application or later
dismissal if appointed.
2. Canvassing of any Member of this Council, directly or indirectly will disqualify the application.
3. The appointment is subject to satisfactory evidence of medical fitness.
4. In the interests of economy, no acknowledgement will be sent. After four weeks from the closing date you
should assume that your Application is unsuccessful.
14.
Signature :
Date: