37-38 Alfred Street,Neath, SA11 1EH

Tel: 01639 617 333Email: info@acnpt.org.ukWeb: www.acnpt.org.uk

CONFIDENTIALJOB APPLICATION FORM

Please complete the form in BLOCK letters, using black ink, or type, (where necessary continue your answers on a separate sheet of paper). All sections on the form must be completed. Cross referencing to an attached curriculum vitae is not acceptable.

All forms should be returned by post or emailed to dean@acnpt.org.uk

Application for the post of: Foot Care Technician

Closing Date for Applications: Friday 27th September 2019Interview date: TBC

PERSONAL INFORMATION

First Name       Surname      

Address               

Post Code       Email address      

Home Tel.       Mobile Tel.      

NI Number      

Please tick the appropriate boxes:

Do you hold a full UK driving license? ☐Do you have use of a car? ☐Are you eligible to work in the UK ☐

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PRESENT OR MOST RECENT EMPLOYERName of employer      

Post held      

Current salary      

Notice required if employed      

Please give a brief outline of the duties and responsibilities of the post.

     

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EMPLOYMENT DETAILSName and address of employer (most recent first)

DatesPosition Reason for leaving

From To                             

                             

                             

                             

                             

Continue on a separate sheet is necessary.

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REFERENCES1. Present or most recent employer 2. Other

Name       Name      

Addresss       Address      

Post Code       Post Code      

Tel No       Tel No      

Email       Email      

May referees be approached prior to interview? Yes No

Please state the number of absences, due to sickness, over the past 12 months.      

EDUCATION AND PROFESSIONAL QUALIFICATIONS

Qualifications Level Grade Date Achieved

                       

                       

                       

                       

                       

                       

                       

                       

                       

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DISABILITY(We are using the word “disability” to include people with obvious disabilities and those with invisible disabilities or persistent health problems)

Have you a disability which requires the provision of specific facilities at interview or for work?

If so, is there anything we could do to assist you? Please give details

     

CANDIDATES SUITABILITY FOR THE POSTPlease demonstrate how your personal qualities, qualifications and experience match the requirements in the Job Description and in the Person Specification for this post. Please attach additional sheets if necessary.

     

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Rehabilitation of Offenders’ Act 1974

The Rehabilitations of Offenders’ Act 1974 allows certain convicted persons, who have not been subsequently re-convicted, to consider their convictions as ‘spent’ However, in order to protect certain vulnerable groups within society, there are a number of posts and professions that are exempt from the provision of the Rehabilitation of Offenders Act 1974. These include posts where, in the normal course of their duties, successful applicants will have direct access to persons who are deemed as vulnerable adults or children, their families and those in receipt of health services. This post is exempt from the provision of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act (Exemptions Order 1975), meaning that you are not entitled to withhold information about convictions which for other purposes are considered spent. A criminal record will not necessarily prevent you from working for ACNPT. This will depend on the nature of the job and the circumstances of your offence/s.

Have you ever been convicted of a criminal offence? YES / NO

If you have been convicted of a criminal offence, please enclose details in a sealed envelope, with a stamped addressed envelope. This will be returned to you unopened in the event that you are not shortlisted for the post.

Your offer of employment may be subject to a satisfactory disclosure from the Disclosure and Barring Service (DBS) (formerly CRB). Failure to reveal information relating to any convictions could lead to withdrawal of an offer of employment. Any information will be confidential and will only be considered in relation to posts to which the order applies.

SIGNATURE

The information given in this application is, to the best of my knowledge, true and accurate.I understand that any false declarations may lead to the withdrawal of a job or termination of employment.

Canvassing will disqualify your application.

Signature of applicant      

Date      

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Registered Office:37-38 Alfred Street, Neath,SA11 1EH Charity No. 1105203 Company No. 4193486. Age Connects Neath Port Talbot is the operating title of Age Concern Neath Port Talbot