Job Application

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Name
Address
Do you have any Spent / Unspent Criminal Convictions?
Do you driver Licence & have access to a car (some posts only)?
Do you have Access to a vehicle?

RELEVANT EDUCATION / QUALIFICATIONS (starting with most recent)

Click or drag files to this area to upload. You can upload up to 10 files.

CURRENT (OR MOST RECENT) EMPLOYMENT

Employer name
Address

PREVIOUS EMPLOYMENT / VOLUNTEERING / CARING HISTORY

SUPPORTING STATEMENTS

REFEREES

Name

Equality and Diversity or Equal Opportunity Form

In accordance with our Equality and Diversity or Equal Opportunity Policy, we are monitoring job applications to ensure that we provide equal opportunities to any job applicant and make sure that discrimination does not occur because of race, sex, sexual orientation, gender reassignment, religion or belief, marital or civil partnership status, age, disability, or pregnancy and maternity. So that we can assess the success of this policy, we have set up a system of monitoring all job applications. We would be grateful, therefore, if you would complete the questions on this monitoring form and return it with your application form. We have asked for your name in order to enable us to monitor applications at the shortlisting and appointment stage. All information supplied will be treated in confidence and will not be seen by staff directly involved in the appointment. The monitoring form will be detached from your application form, stored separately and used solely to provide statistics for monitoring purposes. Thank you for your help.
Gender Assigned at Birth
Which of the Following Best Reflects Gender Identity
Does Gender Align with Gender Assigned at Birth
Preferred Title
Marital Status
Ethnic Origin
Religion or Belief
Do you consider yourself to be disabled under the Equality Act 2010?
(The Disability Discrimination Act (1995) – still in force under the Equality Act 2010 – defines disability as “a physical or mental impairment that has a substantial, long-term and adverse effect on a person’s ability to carry out day to day activities.)
Age Range
Sexual Orientation

Data Protection

The Company treats data collected for reviewing equality of opportunity in recruitment and selection in accordance with its data protection policy. [Please see the Company’s job applicant privacy notice]. I consent to the Company processing the data supplied in this form for the purposes of equal opportunities monitoring in recruitment and selection. I understand I may withdraw my consent to the processing of this data at any time by notifying

DECLARATION

I confirm that to the best of my knowledge the information contained in this application is correct and I understand that withholding, falsification or omission of relevant information may result in employment being terminated. I understand that the information on this application will be stored by Cura in accordance with the principles laid down by GDPR and Cura’s Confidentiality and Records policy.