Intensive Mentors

Personal Information

Your Contact Details

Name*

Title First Name

Last Name*

Previous Last Name

Home Address*

Street Address Address Line 2 Town County Postcode

Home Telephone No.

Email*

Please select how we may contact you*

Post

Phone

Email

I will provide alternative details

Alternative address for communications

Street Address Address Line 2 Town County Postcode

Alternative telephone for communications

General Information

National Insurance Number*

You can obtain this information from the Department of Social Security. If appointed, you will be required to produce documentary evidence of your National Insurance number before you take up the post. If you do not have this, you will be asked for alternative documentation to show that you are allowed to work in the UK.

Do you have a current UK driving licence?*

Do you need a work permit to be employed in the UK?*

Do you have any current endorsements?*

Please give brief details of your endorsements

Application Information

If you are successful, when could you start this job?*

Are you aware of any matter, which might call into question your integrity as an employee or bring you/or Salus into disrepute.*

Please give brief details of your disrepute

Reason for Application*

Using the job description and person specification as a guide, please clearly explain how your qualifications, experience and skills demonstrate your suitability for this post. Please give as much information as possible or we will not be able to shortlist your application.

Where did you see this post advertised?*

Employment

Present or most recent employment

Name of Employer

Employer Address

Street Address Address Line 2 Town County Postcode Country

Job Title

Salary

Date started

Date of leaving (if applicable)

Main duties and responsibilities

Previous Employment

Previous Employment*

Please give details of all employment using the + button (below) to add each additional entry. You must explain any gaps in your job history.

Name and full address of Employer

Dates

Job Held

Qualifications

Qualifications Achieved*

Please add ALL qualifications, using the + button for all new entries. Include Secondary, Higher and/or Further Education

School / College / University attended

Qualifications

Grade (if applicable)

Year taken

Membership of Professional Organisations and Institutions

Name

Date achieved

Membership status

By examination (Yes/No)

Other Skills and Interests

Please including languages (spoken/written), computers, details of any public duties (community or voluntary work experience) etc.

Referees

Give details of two people to whom you are not related and to whom a request for a reference can be made; one should be your current employer, or if you are currently unemployed, your last employer. In the case of school / college / university leavers, your tutor. In certain circumstances a reference may be requested from any of your previous employers. . Referees will be contacted if you are invited to interview.

Reference 1

Name*

First Name Last Name

Relationship to you*

Address*

Street Address Address Line 2 Town County Postcode Country

Email Address*

Phone

Reference 2

Name*

First Name Last Name

Relationship to you*

Address*

Street Address Address Line 2 Town County Postcode Country

Email Address*

Phone

Consent

Have you ever been cautioned, convicted or received a Police Reprimand or Warning?*

As this post is exempt from the Rehabilitation of Offenders Act (ROA) 1974 you must disclose details of any spent or unspent cautions or convictions. Appointment to posts exempt from the ROA will be subject to the successful candidate obtaining an enhanced disclosure from the Criminal Records Bureau to Salus’ satisfaction. We would also ask that you also make known details of any police reprimands, cautions or warnings that are likely to be disclosed by the request of an enhanced disclosure from the Criminal Records Bureau. For all other posts, only unspent cautions or convictions need to be disclosed.

Yes

No

If you have answered yes, please provide of any relevant cautions or convictions

How we use recruitment and selection information

Job application

Intensive Mentors

Important

Application form - Intensive Mentors

Personal Information

Your Contact Details

General Information

Application Information

Employment

Present or most recent employment

Previous Employment

Qualifications

Referees

Reference 1

Reference 2

Consent