Linkability Care and Support in the Lancashire Community

Job Application

Complete and send this Form to send your job application online.

The online job application form includes a 'Declaration' relating to Criminal Record Disclosure.

Post applied for
Where did you hear of this vacancy?
Surname
First Name(s)
Address
Post Code
Home Tel No
Mobile No
Work Tel No
Can we ring you at work?Yes No
Date of Birth
SexMaleFemale

REFERENCES

Please give details of two people to whom we may apply for references. One must be your present or most recent employer (if unemployed), the other a person not related to you, who has known you for at least two years.

REFEREE 1
JOB TITLE
Name and address:
Post Code
Tel No:
How is this referee known to you?
Can we approach this person before interview?Yes No

REFEREE 2
JOB TITLE
Name and address:
Post Code
Tel No:
How is this referee known to you?
Can we approach this person before interview? Yes No
What is your current salary?
When would you be free to take up a new appointment if selected?

EDUCATION

SCHOOL

EstablishmentDate fromDate toQualifications obtained with subjects, levels, grades and dates

FURTHER EDUCATION

EstablishmentDate fromDate toQualifications obtained with subjects, levels, grades and dates

DETAILS OF ANY PROFESSIONAL QUALIFICATIONS

Qualification obtainedAwarding BodyDate

ANY OTHER RELEVANT TRAINING

HOBBIES AND INTERESTS THAT MAY BE RELEVANT TO THIS POST

WORK HISTORY

Please give details of your previous experience. Start with the current or most recent. Please explain any gaps in your employment record (including carer’s breaks, ie family commitments). You may include paid and voluntary work.

Job title
Name and address of employer
Date from
Date to
Brief description of the job
Reason for leaving
Job title
Name and address of employer
Date from
Date to
Brief description of the job
Reason for leaving
Job title
Name and address of employer
Date from
Date to
Brief description of the job
Reason for leaving
Job title
Name and address of employer
Date from
Date to
Brief description of the job
Reason for leaving
Job title
Name and address of employer
Date from
Date to
Brief description of the job
Reason for leaving

ADDITIONAL INFORMATION

Please use this space to explain why you have applied for this job and what qualities you think you could bring. Identify any relevant skills or experience you may have gained which you feel would support your application.

(Maximum characters: 5000)
You have characters left.

CONVICTIONS AND/OR CAUTIONS

Do you have any convictions, cautions or pending issues?Yes No
If yes, please give details below:

This post is subject to Section 4 (20 of the Rehabilitation of Offenders Act 1974 (except Order 1975).
Do you have a clean driving licence?Yes No
If No, please declare your convictions:


The post is subject to Standard/Enhanced Disclosure via the Independent Safeguarding Authority under the vetting and barring scheme and therefore you must also answer the following question:
Are you aware of any police enquiries undertaken following allegations made against you, which may have a bearing on your suitability for this post?Yes No

If yes, please give details below:

View Declaration

I confirm that the information I have given on this form is correct and complete, and that misleading statements may be sufficient for cancelling any agreements made. I understand that the post is subject to ENHANCED DISCLOSURE via the Independent Safeguarding Authority under the vetting and barring scheme (you must click the link above to activate this)