Zinc Arts Applicant Information Form

Please complete this form clearly in type or black pen

All information given will be treated as strictly confidential
Position applied for
Office use only
Surname/family name
First name/s
Address
aytime contact number!
"mail!
o you consider yourself to have a disability# YES/NO
Office use only
Please give details of any conditions or disabilities that may re$uire support or facilitation
during employment
%
Secondary education
&'ame of school(
From ) to "*aminations passed / grades
Office use only
Further / higher education
&'ame of college(
From ) to "*aminations passed / grades
Office use only
+ocational / other studies
&'ame of centre, body,
etc-(
From ) to "*aminations passed / grades
Office use only
1
This information is required to help us fulfil our legal responsibilities and to assist with the employment of disabled
people. All Disabled people that meet seletion riteria will be guaranteed an inter!iew.
2
Professional $ualifications / membership of professional bodies
Office use only
o you hold a full, valid ./ driving licence# YES/NO
0areer 1istory " #urrent or most reent details first
$lease detail your omplete wor% history and all time ta%en for areer brea%s& sabbatials& studies& parenting& et.
$lease do not send us your #'. You may add one additional page of A( if you wish. N)* +f offered the position we
will as% to see a reent payslip to onfirm salary.
2ob/Activity/
'ame of "mployer
Position and main responsibilities From)to 3eaving
salary
4eason for
leaving/change
3
1ave you given notice to your current employer &if
applicable(#

YES / NO / N/A
1ow soon could your new employment commence#
o you have any other commitments we should be
aware of#
Please outline your I05 skills
Office use only
Software 0ompetence ,e.g.& -basi %nowledge of-& -!ery familiar with-& et..
Please give details of any criminal convictions
6
Office use only
Please give details of two referees Office use only
Please continue to ne*t page
2
+f employed& you will ome in ontat with !ulnerable people and hildren& and may !isit Soial #are
establishments. /e therefore require shortlisted andidates to delare any past/spent on!itions. 0owe!er& this
information will not neessarily be a bar to employment.
4
Please tell us why you think your e*perience and $ualifications make you suitable for the post &please refer
to the person specification and 7ob description- 8ou must address every item in the person specification-
Please limit your answer to no more than two sides of A9(
5
+ ertify that& to the best of my %nowledge& the information + ha!e pro!ided is true. + understand that false
information or failure to dislose riminal on!itions may& in the e!ent of employment& lead to instant dismissal.
Signature of applicant ate
6