IMPORTANT INFORMATION ON HOW TO COMPLETE THIS FORM PLEASE READ CAREFULLY BEFORE COMPLETING THIS FORM. WE WILL NOT BE ABLE TO SHORTLIST YOU FOR AN INTERVIEW IF YOU HAVE NOT FOLLOWED THESE INSTRUCTIONS.  CVs cannot be accepted instead of this form. We will not consider any CV sent to us as part of this application.  Please instead ensure that you complete each section of the form. You may add separate sheets as a continuation to any section of the form but please mark these clearly with your name and the position for which you are applying.  Please complete using black ink or type.  Please make sure that that you sign the form and return it by 5 p.m on the closing date. We will not normally consider applications received after the closing date has passed.  We regret that we cannot accept applications sent back via email. You must ensure that we receive your application by post or in person.  The information you give in section 4 (‘Supporting Information’) is particularly important. This will be used to decide whether or not we invite you for interview. Therefore, it is vital that you clearly demonstrate how you meet each of the qualities listed in the ‘Person Specification’ sent with this pack. Please list each of these qualities in turn, clearly setting out how your skills, abilities, knowledge and experience match that required for the post. You can use examples from your home life, voluntary or part-time work, job clubs, hobbies, college etc, as well as any gained through work in order to demonstrate how your knowledge, skills and experience match that required for the post. Brighton YMCA Registered Office Steine House 55 Old Steine Brighton BN11NX Telephone 01273 220900 Fax 01273 220999 www.brightonymca.co.uk Chief Executive John F Osborne Supported Housing – Supporting Potential APPLICATION FOR EMPLOYMENT - CONFIDENTIAL Position applied for Closing Date SECTION 1: PERSONAL DETAILS Please note: all details given in this section are confidential. This page is removed before shortlisting applicants for interview. Only the name you wish to be known by will be passed on to those involved in the shortlisting process. SURNAME FORENAMES TITLE (Mr/Mrs/Miss/Ms/Other) ADDRESS KNOWN AS TELEPHONE NUMBER (Day) POSTCODE (Evening) DATE OF BIRTH NATIONAL INSURANCE NUMBER NATIONALITY DISABILITY AND ARRANGEMENTS FOR INTERVIEW Please note: A disability or health problem does not prevent full consideration for employment. We ask these questions to support positive action in employment for people with disabilities and to ensure full access to interview. The Equality Act 2010 defines a person as ‘disabled’ if they have a ‘physical or mental impairment’ that has ‘a substantial and long-term adverse effect on their ability to perform normal day-to-day activities.’ We offer a guaranteed interview to all candidates with a disability as defined above who meet the essential skills required for this post. Please tick this box if you would like your application to be considered under this scheme Please describe any arrangements needed to assist you if called for interview: FOR OFFICE USE ONLY: CANDIDATE NO: KNOWN AS: SECTION 2: EDUCATION, TRAINING AND DEVELOPMENT QUALIFICATIONS Please list any relevant qualifications you hold, starting with the most recent. We will require you to provide proof of any qualifications stated before we can offer you a post. Qualification Subject(s) Result/Grades Membership of professional bodies/organisations please state name of professional body/bodies and status/level of membership Other relevant training please describe any other relevant training you have undertaken starting with most recent first SECTION 3: EMPLOYMENT / VOLUNTARY WORK RECENT EMPLOYMENT/VOLUNTARY WORK Please list any employment, part or full time, or voluntary work undertaken within the last 5 years, starting with the most recent first. Please make sure you explain any gaps between positions. Continue onto separate sheets if necessary, ensuring your name appears at the top of each additional page Position held and main responsibilities Dates from/to Employer/organisation Please state if part-time (PT), full-time (FT) and reason Name and address or voluntary (Vol) for leaving OTHER RELEVANT EMPLOYMENT/VOLUNTARY WORK Please outline any other employment or voluntary work you have undertaken that you consider to be relevant to this post SECTION 4: SUPPORTING INFORMATION This is the most important part of the application form. The information given here will determine whether or not you are shortlisted for this post. Please refer to the enclosed person specification and instructions for completion. Please use each of the criteria of the Person Specification as a heading to explain, drawing upon your personal and work experience; education; and training, how you can satisfy each requirement. Please continue onto additional sheets if necessary, clearly stating your name at the top of each sheet. SECTION 4: SUPPORTING INFORMATION (continued) SECTION 5: REFEREES Please give details of two referees, one of which should be your current or most recent employer. Referees must not be related to you. REFEREE 1: May we contact this referee prior to interview? Y N REFEREE NAME JOB ROLE/POSITION (where applicable) ADDRESS POSTCODE TELEPHONE NO RELATIONSHIP TO YOU? EMAIL ADDRESS REFEREE 2: May we contact this referee prior to interview? Y N REFEREE NAME JOB ROLE/POSITION (where applicable) ADDRESS POSTCODE TELEPHONE NO RELATIONSHIP TO YOU? EMAIL ADDRESS ADDITIONAL REFEREE If you have been in your current post for less than 2 years please also supply reference details for your employer prior to that May we contact this referee prior to interview? Y N REFEREE NAME JOB ROLE/POSITION (where applicable) ADDRESS POSTCODE TELEPHONE NO EMAIL ADDRESS RELATIONSHIP TO YOU? SECTION 6: CURRENT/RECENT SALARY AND NOTICE REQUIREMENTS Please state your current/most recent Annual salary Period of notice required for current position, if successful SECTION 7: CRIMINAL CONVICTIONS Please give details of any criminal convictions you hold, whether spent or not. This is required under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 and Exceptions (Amendment) Order 1986) because this post requires working with vulnerable adults. Information given here will be treated in confidence and considered only in relation to the post for which you are applying. Convictions listed here will not necessarily prevent employment within Brighton YMCA. Please note, however, that failure to disclose convictions at this stage could result in dismissal if employed by Brighton YMCA. SECTION 8: DATA PROTECTION AND DECLARATION DATA PROTECTION ACT 1998 Please read carefully and sign if you agree to the following Data Protection statement Any data held about you will be stored securely and access to it restricted. A record of the shortlisting process and application forms for those invited to interview will be kept for six months from interview date. If you are the successful applicant, relevant information will be taken from this form and used as part of your personnel record. SIGNED DATE DECLARATION Please read carefully and sign I declare that the information held in this application is complete and correct. I understand that any false or misleading information, or failure to disclose relevant information, may result in my application being destroyed or in termination of employment SIGNED DATE Please return completed form and monitoring information to address on front of form. Please make sure that you return your application before 5pm on the closing date. We will not normally consider applications received after the closing date has passed. If you require this in large print, translation or a different format please let us know Registered Office: Steine House, 55 Old Steine, Brighton,BN1 1NX. Telephone: 01273 220900 Fax: 01273 220999 A company limited by guarantee not having a share capital Registered in England Company No. 329407 Registered Charity No. 800987 Registered Provider of social housing No. H3835