IMPORTANT INFORMATION ON HOW TO COMPLETE THIS FORM

IMPORTANT INFORMATION ON HOW TO COMPLETE THIS
FORM
PLEASE READ CAREFULLY BEFORE COMPLETING THIS FORM.
WE WILL NOT BE ABLE TO SHORTLIST YOU FOR AN INTERVIEW IF YOU HAVE NOT
FOLLOWED THESE INSTRUCTIONS.

CVs cannot be accepted instead of this form. We will not consider any CV sent to
us as part of this application.

Please instead ensure that you complete each section of the form. You may add
separate sheets as a continuation to any section of the form but please mark these
clearly with your name and the position for which you are applying.

Please complete using black ink or type.

Please make sure that that you sign the form and return it by 5 p.m on the closing
date. We will not normally consider applications received after the closing date has
passed.

We regret that we cannot accept applications sent back via email. You must ensure
that we receive your application by post or in person.

The information you give in section 4 (‘Supporting Information’) is particularly
important. This will be used to decide whether or not we invite you for interview.
Therefore, it is vital that you clearly demonstrate how you meet each of the qualities
listed in the ‘Person Specification’ sent with this pack. Please list each of these
qualities in turn, clearly setting out how your skills, abilities, knowledge and
experience match that required for the post. You can use examples from your home
life, voluntary or part-time work, job clubs, hobbies, college etc, as well as any
gained through work in order to demonstrate how your knowledge, skills and
experience match that required for the post.
Brighton YMCA
Registered Office
Steine House
55 Old Steine
Brighton
BN11NX
Telephone 01273 220900
Fax 01273 220999
www.brightonymca.co.uk
Chief Executive
John F Osborne
Supported Housing – Supporting Potential
APPLICATION FOR EMPLOYMENT - CONFIDENTIAL
Position applied for
Closing Date
SECTION 1: PERSONAL DETAILS
Please note: all details given in this section are confidential. This page is removed before
shortlisting applicants for interview. Only the name you wish to be known by will be passed on
to those involved in the shortlisting process.
SURNAME
FORENAMES
TITLE (Mr/Mrs/Miss/Ms/Other)
ADDRESS
KNOWN AS
TELEPHONE NUMBER (Day)
POSTCODE
(Evening)
DATE OF BIRTH
NATIONAL INSURANCE NUMBER
NATIONALITY
DISABILITY AND ARRANGEMENTS FOR INTERVIEW
Please note: A disability or health problem does not prevent full consideration for employment.
We ask these questions to support positive action in employment for people with disabilities
and to ensure full access to interview.
The Equality Act 2010 defines a person as ‘disabled’ if they have a ‘physical or mental
impairment’ that has ‘a substantial and long-term adverse effect on their ability to perform
normal day-to-day activities.’
We offer a guaranteed interview to all candidates with a disability as defined above who
meet the essential skills required for this post.
Please tick this box if you would like your application to be considered under this scheme
Please describe any arrangements needed to assist you if called for interview:
FOR OFFICE USE ONLY:
CANDIDATE NO:
KNOWN AS:
SECTION 2: EDUCATION, TRAINING AND DEVELOPMENT
QUALIFICATIONS Please list any relevant qualifications you hold, starting with the most
recent. We will require you to provide proof of any qualifications stated before we can offer you
a post.
Qualification
Subject(s)
Result/Grades
Membership of professional bodies/organisations please state name of
professional body/bodies and status/level of membership
Other relevant training please describe any other relevant training you have undertaken
starting with most recent first
SECTION 3: EMPLOYMENT / VOLUNTARY WORK
RECENT EMPLOYMENT/VOLUNTARY WORK Please list any employment, part or
full time, or voluntary work undertaken within the last 5 years, starting with the most recent
first. Please make sure you explain any gaps between positions. Continue onto separate sheets
if necessary, ensuring your name appears at the top of each additional page
Position held and main responsibilities
Dates from/to
Employer/organisation
Please state if part-time (PT), full-time (FT)
and reason
Name and address
or voluntary (Vol)
for leaving
OTHER RELEVANT EMPLOYMENT/VOLUNTARY WORK Please outline any other
employment or voluntary work you have undertaken that you consider to be relevant to this post
SECTION 4: SUPPORTING INFORMATION This is the most important part of the
application form. The information given here will determine whether or not you are shortlisted
for this post. Please refer to the enclosed person specification and instructions for completion.
Please use each of the criteria of the Person Specification as a heading to explain, drawing
upon your personal and work experience; education; and training, how you can satisfy each
requirement. Please continue onto additional sheets if necessary, clearly stating your
name at the top of each sheet.
SECTION 4: SUPPORTING INFORMATION (continued)
SECTION 5: REFEREES Please give details of two referees, one of which should be your
current or most recent employer. Referees must not be related to you.
REFEREE 1: May we contact this referee prior to interview?
Y
N
REFEREE NAME
JOB ROLE/POSITION (where applicable)
ADDRESS
POSTCODE
TELEPHONE NO
RELATIONSHIP TO YOU?
EMAIL ADDRESS
REFEREE 2: May we contact this referee prior to interview?
Y
N
REFEREE NAME
JOB ROLE/POSITION (where applicable)
ADDRESS
POSTCODE
TELEPHONE NO
RELATIONSHIP TO YOU?
EMAIL ADDRESS
ADDITIONAL REFEREE If you have been in your current post for less than 2 years please also
supply reference details for your employer prior to that
May we contact this referee prior to interview?
Y
N
REFEREE NAME
JOB ROLE/POSITION (where applicable)
ADDRESS
POSTCODE
TELEPHONE NO
EMAIL ADDRESS
RELATIONSHIP TO YOU?
SECTION 6: CURRENT/RECENT SALARY AND NOTICE REQUIREMENTS
Please state your current/most recent Annual salary
Period of notice required for current position, if successful
SECTION 7: CRIMINAL CONVICTIONS Please give details of any criminal convictions
you hold, whether spent or not. This is required under the Rehabilitation of Offenders Act 1974
(Exceptions) Order 1975 and Exceptions (Amendment) Order 1986) because this post requires
working with vulnerable adults. Information given here will be treated in confidence and
considered only in relation to the post for which you are applying. Convictions listed here will not
necessarily prevent employment within Brighton YMCA. Please note, however, that failure to
disclose convictions at this stage could result in dismissal if employed by Brighton YMCA.
SECTION 8: DATA PROTECTION AND DECLARATION
DATA PROTECTION ACT 1998 Please read carefully and sign if you agree to the
following Data Protection statement
Any data held about you will be stored securely and access to it restricted. A record of the
shortlisting process and application forms for those invited to interview will be kept for six months
from interview date. If you are the successful applicant, relevant information will be taken from
this form and used as part of your personnel record.
SIGNED
DATE
DECLARATION Please read carefully and sign
I declare that the information held in this application is complete and correct. I understand that
any false or misleading information, or failure to disclose relevant information, may result in my
application being destroyed or in termination of employment
SIGNED
DATE
Please return completed form and monitoring information to address on front of form.
Please make sure that you return your application before 5pm on the closing date. We will
not normally consider applications received after the closing date has passed.
If you require this in large print, translation or a different format please let us
know
Registered Office: Steine House, 55 Old Steine, Brighton,BN1 1NX. Telephone:
01273 220900 Fax: 01273 220999
A company limited by guarantee not having a share capital
Registered in England Company No. 329407 Registered Charity No.
800987 Registered Provider of social housing No. H3835