Application Form

The Ormerod Home Trust Ltd

Application Form

	Application for post of: *

	Surname *
	Fornames *
	Address *

	Postcode *
	E-mail Address

	Telephone Home
	Telephone Mobile
	Telephone Work
	Date of Birth (dd/mm/yyyy)
	Present Employer
	Present Position
	Date of Appointment (dd/mm/yyyy)
	Current Salary
	Previous Positions Please give dates employed and reason for leaving

	Details of Secondary School Attended

	Qualifications, Grades & Dates

	Further and Professional Education

	Membership of Professional Bodies

	Details of any other specialised training (not covered in previous section)

	Experience or Achievements

	Have you ever been convicted of any criminal offence
	As The Ormerod Home Trust meets the requirements in respect of exempted questions under the Rehabiliation of Offenders Act 1974, if you are offered employment, you will be subject to a criminal record check from the Criminal Records Bureau before the appointment is confirmed. The post you are applying for is subject to an Enhanced Disclosure. The Enhanced Disclosure contains details and dates of both spent and unspent convictions, as well as cautions, reprimands and final warnings held on the Police National Computer. If yes, please specify the date of conviction, Court, Nature of the offense and sentance imposed

	Do yoy hold a current (less than six months old) Enhanced Disclosure
	Please State if you have a personal/family relationship with any current staff member or Trustee

	Please specify

	Do you hold a current driving licence?
	Are you registered under the Disabled Persons Act?
	Registered No
	How did you hear of this vacancy?

	Period of Notice Required to terminate current employment

	References Please give the names, addresses and occupations of two referees. Ideally one should be from your present or last employer.