Voluntary Action Shetland Scottish Charity Number SC017286 APPLICATION FOR EMPLOYMENT VACANCY: Shetland Befriending Scheme, Part Time-16hrs, 60+ Years Development Workers d CLOSING DATE: Friday 4 th Oct 2013 PERSONAL DETAILS FULL NAME: HOME ADDRESS TELEPHONE NUMBERS (including STD Code) Home: Mobile: Work: E-mail: National Insurance Number: Postcode: Nationality : Do you have a disability? Yes No (Please delete as appropriate) If Yes, are there any particular arrangements you require us to make to enable you to attend for interview? For example - a sign language interpreter, location with ramp or information in large print etc. * Definition of a disability A physical or mental impairment which has substantial long term adverse effect on the ability to carry out normal day to day activities. Current Period of Notice: 1
EDUCATIONAL QUALIFICATIONS (If you are invited to interview you may asked to provide evidence of qualifications) State name of school, college, university or examining body awarding the qualification Qualification Date Achieved Method Obtained: e.g. by examination experience or election TRAINING Please give brief details of relevant training other than those stated above. Including apprenticeships MEMBERSHIP OF PROFESSIONAL BODIES Institute / Professional Body Class of Membership (Including registration No. where appropriate) Date Achieved Method Obtained: e.g. by examination experience or election 2
CAREER SUMMARY Please provide brief details of your employment history including your current or most recent employment. Please put these in chronological order starting with most recent. You must explain any gaps not accounted for by employment, education or training. VAS reserves the right following notification to you to contact any previous employer for information. From To Employers name and address Job title and brief outline of work area Reason for leaving 3
FURTHER DETAILS OF RELEVANT EXPERIENCE Taking account of the criteria in the enclosed Person Specification, please use this section to give further details of your most relevant experience indicating particular skills/abilities as it relates to the post now applied for. Why are you applying for this post? Do you hold a current full driving licence? Yes No Do you have a suitable vehicle for use in your employment? Yes No (Tick as appropriate) 4
REFERENCES Please give the names of two persons not related to you who are able to give confidential information with regard to your work. One referee must be from your current or most recent employment, preferably your immediate supervisor. (If you have not been employed since leaving school/college, then you must give a tutor as a replacement). Your referees will be contacted only if you are successful in being short-listed for interview. If you do not wish your referee(s) to be contacted prior to interview please tick here. Name: Address: Name: Address: Designation: Telephone Number (including STD Code) Designation: Telephone Number (including STD Code) Data Protection VAS is registered as a data user under the Data Protection Act (1984) (1998). The information provided by you, including, if applicable, any sensitive data which includes information regarding your physical or mental health will be processed by the VAS solely for the purpose of evaluating your application for employment. The information which you have provided is likely to be disclosed to the interview panel. Please confirm that you explicitly consent to such processing taking place by ticking this box. Important - Read carefully before signing Protection of Vulnerable Groups: If this post is considered Regulated Work with Vulnerable Children and/or Protected Adults, under the Protection of Vulnerable Groups (Scotland) Act 2007. Preferred candidates will be required to join the PVG Scheme or undergo a PVG Scheme update check. More information on the PVG Scheme is available at www.disclosurescotland.co.uk/guidance Probationary Period: A probationary period may be applied Dependant on the nature of the post you may be required to join the regulated workforce I certify that all statements given by me on this form are true and correct to the best of my knowledge. I realise that if I am employed and it is found that such information is false or that I have withheld information, I am liable to be dismissed. In that regard, I authorise VAS to check any of the above information. Signature: Date: Thank you for providing the information requested. 5