Download an editable Word version of this document.


Example


Responsible to:


Employer's Name.


Location


Area in which the post will be based (e.g. Belfast, Bangor, Lisburn etc).


Closing date


Applications should be in no later than __________


Applicant's details


Name (Mr/Mrs/Ms)_______________________

Address _______________________________

______________________________________

Post Code _____________________________

Telephone _____________________________

E-mail ________________________________

Do you hold a current driving license? Yes/No.

Do you have access to a car? Yes/No.


Employment record


Please list your employers, and details of the position held, starting with the most recent and include any periods of unemployment. Please provide the same information for any previous employers on a separate sheet.


Employer:_______________________

Nature of Position:_______________

From - To:_________________

Reason for leaving:________________


Experience and skills


There are no formal qualifications necessary for this post. Please use the space provided below to explain what relevant experience and skills you could bring to this post. You may continue on a separate sheet if necessary.


Motivation


Please state briefly why you applied for this post.


Other relevant Information


Please use the space below to provide any relevant information in support of your application.


Hobbies and interests


Please use the space provided to list any hobbies or interests that you have.


References


Please list details of two referees (one of whom should be your most recent employer).


Referee One


Name ____________________


Address __________________


Address __________________


Postcode _________________


Telephone (daytime) ________________


Referee Two


Name ____________________


Address __________________


Address __________________


Postcode _________________


Telephone (daytime)________________


May I contact your referees prior to any offer of employment? Yes/No.


Rehabilitation of Offenders (Exceptions) Order (NI) 1979


You are not normally on application for employment, required to declare information about convictions that are 'spent'. However, owing to the nature of the post for which you are applying, the above Order prohibits you from withholding information about such convictions.

Have you ever been convicted of a criminal offence? Yes/No.


If you answered 'yes' please give the nature of the conviction.


Completed application


You should return your completed application form by dd/mm/yy to:


Employer's name.
Employer's address/PO Box number.


Declaration


I declare that the information on this application is correct.


Signed ________________ Date _____________