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APPLICATION FORM - Guidance - This application form will consist of three sections. Section 1 will ask you to provide us with yours personal details; Section 2 is relevant to your education, qualifications and experience; and Section 3 requests information on referees and details of any criminal convictions. The Kent Surrey Sussex Air Ambulance Trust will accept electronic copies of this application form. All electronic forms must be sent to the Trust s HR & Support Administrator, Mr Michael Small: michaels@kssairambulance.org.uk. If you send the application via email, we request that the document is compatible with Microsoft Word or Adobe Reader. Any applications that are received after 11:59pm on the closing date will not be accepted. If you are sending your application by post, the Trust will only accept any applications which are received up to, and on the date of closure. All hard copy applications must be sent to our Marden base unless otherwise stated. Decisions about who will be selected for interview will be based only on information you provide on this application form. We ask that you fill in this form as completely and as clearly as possible. The Trust will not accept any pre-prepared curriculum vitae as a substitute for this application form, and will only accept supporting documentation with the application, as long as it is considered necessary and kept to a minimum. Copies of references and qualification certificates should not be enclosed with this application. If at any stage in the recruitment process it is discovered that you have provided false or misleading information, your application will be disqualified. When completing this application, please demonstrate any skill, knowledge and experience you feel is necessary to the role you are applying for. A job description should have been provided to you in support of this form; however you can request a copy from the Trust by contacting the HR & Support Administrator. PLEASE COMPLETE THIS FORM IN BLACK INK OR TYPESCRIPT USING BLOCK LETTERS. Full Name: What position are you applying for?

- Section 1: Personal Details - Home Address: Postcode: Contact Details: Please indicate how you would prefer us to contact you by providing details and marking relevant tick box(es). Home Telephone Number: Mobile Number: Business Telephone Number: Email Address: Do you hold a driving licence? Do you have any current endorsements on your licence? (If yes, please outline your current endorsements and the reasons for them) Do you need a work permit to be employed in the UK? Can you provide proof that you are legally allowed to work in the UK? Are you able to provide the original of one of the following: a British Passport, a UK residence permit or an equivalent legal document that shows that you are entitled to work in the UK? (Evidence of this document will be requested if you are shortlisted for interview)

How much notice would you be required to give your current employer?: If you were offered a position with the Trust would you continue to work in another capacity? Are there any restrictions regarding your employment? (If yes, please outline restrictions below. Additional information can be attached to your application) Do you consider yourself to be disabled? Are there any reasonable adjustments which you feel should be made to our recruitment process to assist you in your application? (If yes, please outline these adjustments)

- Section 2: Education, Qualification & Experience - Employment History: Please can you outline your employment history below, describing in detail the main duties and responsibilities of your most recent, current or most relevant position(s). Please ensure that a complete history is included. Current / most recent employer / organisation Name of organisation: Position: Address: Employment Dates From: To: Brief description of your duties: Reason(s) for leaving: Previous employer / organisation Name of organisation: Position:

Address: Employment Dates From: To: Brief description of your duties: Reason(s) for leaving: Other previous employment Name of organisation Position held and main responsibilities From Dates To Reason(s) for leaving

Membership of professional bodies / association Professional Body Membership Level Date Joined Registration Number / Ref Qualifications and Education: Please tell us about your education and qualifications which you feel are relevant to this position. Please start with your earliest qualification, and include any courses or qualifications you may be currently undertaking. Name of Education Establishment Subject or Qualification Studied Qualification / Level Date Obtained

Training: Please list any training which you have received or courses which did not lead to a qualification, which you believe have relevance to the position you are applying for. Training Course Organiser (if known) Date Joined

Experience: Using the job description and any other supporting documentation, please outline how your previous experience or skills will demonstrate your suitability for the post. Please use a separate sheet if required.

- Section 3: References - In the boxes below can you provide the Trust with two nominated referees. We request that one of your referees is your current or most recent employer. If you do not currently have an employer, one reference must be from your previous employer. If you have not yet been employed, please provide two references from your educational establishments/schools. Please do not use any relatives, friends or partners. If you require advice on the most suitable referees, please contact Michael Small or the Kent, Surrey & Sussex Air Ambulance. Referee 1 Name: Position: Organisation: Address: Email Address: Tel : Mobile : Referee 2 Name: Position: Organisation: Address: Email Address:

Tel : Mobile : Please confirm if we can start obtaining references without further approval, if we offer you the position you have applied for? To your knowledge are you related to any Trustee or member of staff here at Kent, Surrey & Sussex Air Ambulance Trust? Name of Trustee or employee: Relationship: Criminal Convictions Do you have any criminal convictions? (If, please give details below. This should exclude any spent convictions under Section 4 (2) of the Rehabilitation of Offenders Act 1974) Recruitment Policy It is the Trust s policy to employ the best qualified personnel and provide equal opportunities for the advancement of it employees, including promotion and training. The Trust aims not to discriminate against any person because of race, colour, age, national origin, sexual orientation, marital status, religion, beliefs, or disability. For research purposes, please can you outline where you heard about the role you have applied for? Declaration and Signature I confirm that the information supplied in this application form is, to the best of my knowledge, true, accurate and complete. I understand that if this application is found to have any false or misleading statements then my application will be rejected. Signed: Date:

By signing and returning this application form you consent to the Trust using and keeping information about you, provided by you or third parties such as referees relating to your application or future employment. This information will be used solely in the recruitment process and will be retained for twelve months from the date on which you are informed whether you have been invited to interview, or twelve months from the date of interview. Thank you for completing the form. Please can you send your submission to the attention of the HR and Support Administrator, Mr Michael Small. You can return the application via email or in the post, to the contact details below. michaels@kssairambulance.org.uk Please mark the subject of your email as Private and Confidential followed by the job title. Private & Confidential Mr Michael Small Kent, Surrey & Sussex Air Ambulance Trust Wheelbarrow Park Estate Pattenden Lane Marden TN12 9QJ