T H E P O S T C O D E F O R J E W I S H L I F E. Page Finchley Road London NW3 6ET Tel

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1 JW3 Application form POSITION APPLIED FOR: PERSONAL DETAILS Title First Name(s) Surname Permanent Address Address for correspondence (if different) Postcode Postcode Daytime Telephone Number Evening Telephone Number Mobile Telephone Number Are you holding a UK passport or EU country citizenship? Address Do you have a clean driving licence? If NO, do you have a work visa? If YES, please state work permit number (you will be required to produce this at an interview) EMPLOYMENT RECORD (Please list chronologically, starting with current or last employer and include work experience if this is an application for a first job and apprenticeship Page 1

2 VOLUNTEERING RECORD (Please list chronologically, starting with current or last volunteering role any volunteering that you have undertaken. If you have not done any or it is not relevant to your application then please strike through this section) Page 2

3 EDUCATION, TRAINING AND QUALIFICATIONS starting with the most recent Name of university, college or school Dates From To Examinations taken, results and qualifications gained including vocational qualifications Page 3

4 SUPPORTING STATEMENT Please give any details you feel are relevant in support of your application, including why you are interested in this post. Use additional sheets if necessary. REFEREES Please give the details of two work related referees, including your current or most recent post. Referees will not be contacted without your prior approval. Name: Name: Position: Position: Company: Company: Address Address Telephone Number: Nature of Relationship: Telephone Number: Nature of Relationship: Page 4

5 Convictions Have you ever been convicted of a criminal offence? If so please give details of any unspent convictions. Spent convictions do not have to be declared as the job is not one covered by the Rehabilitation of Offenders Act 1974 (Exceptions) Order NB: If however the job you are applying for involves work with children, young people or vulnerable adults then you need to give details of all spent and unspent convictions Safeguarding Please note that, any offer of employment for successful applicants who will be expected to work with children and/or vulnerable adults on more than a very short term basis, will be subject to written references, the production of a valid and up-to-date enhanced DBS certificate and the reading, agreeing to and signing of JW3 s safeguarding and youth policies. VERIFICATION OF INFORMATION I certify that all information which I have provided is correct. I understand that any false information given may result in a job offer being withdrawn. Signature: Date: In addition, where the job I am applying for involves working with children or vulnerable adults, I declare that there is no reason why I should be considered unsuitable to work with any of those groups and I understand that I am required to reveal details of all spent and unspent convictions under the provision of the Rehabilitation of Offenders Act 1974 (Exceptions) Order Please note that this information will be treated confidentially and fairly. Signature: Date: If you require any special arrangements to be made to assist you if called for interview, please let us know in advance of the interview. Where did you hear about this vacancy? Page 5