Leisure Assistant (Wet) jobs available

  APPLICATION FOR EMPLOYMENT

                                                Form AP2

PRIVATE AND CONFIDENTIAL

Return this form to:   Operations, Manager, Age UK Rotherham, Eastwood Trading
Estate, Fitzwilliam Road, Rotherham, S65 2SL
Or email to: hannah.massey@ageukrotherham.org

Ref: PA Zero

POSITION APPLIED FOR

Personal Assistant Zero hours

  Surname

Address

Forename(s)

Title

                                                                                                       Postcode

Date of birth

NI No.

Telephone

   number

Email address:

Current driving licence?         Yes/No
Groups:                        Expiry Date:

Details of
endorsements

  Are there any restrictions on you taking up employment in the UK?      Yes           No           (please delete as appropriate)
  (If yes, please provide details)

EDUCATION HISTORY

Schools                                                                              Qualifications gained

Colleges/Universities                                                          Qualifications gained

Other training

https://ageukrotherham.sharepoint.com/sites/DigitalImprovementTeam/Shared Documents/Website/Paid
positions/PA Role/25 and Zero hours/APPLICATION FORM Personal Assistant Zero hours_2022.doc

OTHER EMPLOYMENT

Please note any other employment you would continue with if you were to be successful in obtaining this position.

EMPLOYMENT HISTORY (Please complete in full and use a separate sheet if necessary)

FROM - TO

NAME AND ADDRESS
OF EMPLOYER

JOB TITLE AND DUTIES

START/FINISH
SALARY

REASON FOR
LEAVING

Notice required in current post:

https://ageukrotherham.sharepoint.com/sites/DigitalImprovementTeam/Shared Documents/Website/Paid
positions/PA Role/25 and Zero hours/APPLICATION FORM Personal Assistant Zero hours_2022.doc

REFERENCES
Please note here the names and addresses of two persons from whom the company may obtain both character and work experience
references. (One must be from your most recent employer.)

1.

2.

LEISURE

Please note here your leisure interests, sports and hobbies, other pastimes etc.

CRIMINAL RECORD

Please note any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974.  If none please state.  In
certain  circumstances  employment  is  dependent  upon  obtaining  a  satisfactory  basic  disclosure  from  the  Criminal  Records
Bureau/Scottish Criminal Records Office.

GENERAL COMMENTS

Please detail here your specific reasons for this application, your main achievements to date and the strengths you would bring to
this post.

https://ageukrotherham.sharepoint.com/sites/DigitalImprovementTeam/Shared Documents/Website/Paid
positions/PA Role/25 and Zero hours/APPLICATION FORM Personal Assistant Zero hours_2022.doc

Have you had any periods of absence within the last three years?  State length of absence and reason.

DECLARATION (Please read this carefully before signing this application)

1.

2.

I confirm that the above information is complete and correct and that any untrue or misleading information will give my
employer the right to terminate any employment contract offered.

I  agree  that  the  organisation  reserves  the  right  to  require  me  to  undergo  a  medical  examination.    (Should  we  require
further  information  and  wish  to  contact  your  doctor  with  a  view  to  obtaining  a  medical  report,  the  law  requires  us  to
inform you of our intention and obtain your permission prior to contacting your doctor).  I agree that this information will
be retained in my personnel file during employment and for up to six years thereafter and understand that information will
be processed in accordance with the Data Protection Act.

3.    I  agree  that  should  I  be  successful  in  this  application,  I  will,  if  required,  apply  to  the  Criminal  Records  Bureau/Scottish
Criminal Records Office for a basic disclosure.  I understand that should I fail to do so, or should the disclosure not be to the
satisfaction of the company any offer of employment may be withdrawn or my employment terminated.

Signed:                                                                                                  Date:

https://ageukrotherham.sharepoint.com/sites/DigitalImprovementTeam/Shared Documents/Website/Paid
positions/PA Role/25 and Zero hours/APPLICATION FORM Personal Assistant Zero hours_2022.doc

EQUAL OPPORTUNITY MONITORING

Form EO

We are an equal opportunity employer.  The aim of our policy is to ensure that no job applicant or employee receives less favourable
treatment  on  the  grounds  of  race,  colour,  ethnic  or  national  origin,  religious  belief,  political  opinion  or  affiliation,  sex,  marital  status,
sexual orientation, gender reassignment, age or disability, or is disadvantaged by conditions or requirements which cannot be shown to
be justifiable.

Our selection criteria and procedures are frequently reviewed to ensure that indivi...