Bridges Application Form

Personal Details Application for employment as: Surname: Other names: Address:

Preferred telephone number: Preferred email address: If you have a preference for how we contact you, please indicate that here:

Education and Training Please list below as relevant details of your academic qualifications (e.g. GCSEs, A-levels, diplomas, degrees).

Bridges is a project of Memorial Community Church (reg. charity no.: 1133488)

Please list below any professional training or accreditation that you feel is relevant to this application

Information in support of your application Please tell us why you are applying for this job, and why you feel your skills and experience (whether within or outside a paid working environment) qualify you to take up this post. You are advised to write with direct reference to the Job Description and Person Specification for the post. Please be concise as possible in what you write.

Bridges is a project of Memorial Community Church (reg. charity no.: 1133488)

Other Information Have you ever been convicted of a criminal offence?

(declaration subject to the Rehabilitation of Offenders Act 1974)

YES / NO YES / NO

Do you have any disabilities that might affect your application?

Please tell us if: a. there are any reasonable adjustments we can make to assist you in your application b. there are any reasonable adjustments we can make to the job itself to help you carry it out

Do you need a work permit to work in the UK? When can you start work for us? Please specify a date if possible.

YES / NO

References Please give the names and contact details of two persons whom we can approach for references. No approach will be made before a conditional offer of employment is made. 1

Declaration I confirm that to the best of my knowledge the above information is correct. Signature: Date:

Bridges is a project of Memorial Community Church (reg. charity no.: 1133488)