Citizens Advice in East Dorset and Purbeck Ltd
Wareham and Wimborne
Part-time
CONFIDENTIAL APPLICATION FORM

Section 1

Please refer to the Guidance Notes for Applicants before completing this
application form.

We value diversity, promote equality and challenge discrimination. We encourage
and welcome applications from suitably skilled candidates from all backgrounds.

Please let us know if there are any adjustments we can make to assist you in

your application and / or interview? (larger font, greater colour contrast, hearing

loop, wheelchair access, an afternoon interview, etc)

This information will be treated as confidential:

Members of the recruitment panel will consider the information you provide
against the person specification for the role to decide whether you will be
shortlisted for an interview. It is therefore essential that you complete the form
fully so that you clearly demonstrate how you meet each point on the person
specification.

Please note that CVs are not accepted.

Position applied for

Job title

Location

Trainee/Experience Admin Support - Energy Unit  P/T
Working days; Wednesday, Thursday and Friday’s
Office Based Wareham and Wimborne

Entitlement to work in the UK
To take up this post you must have the right to work in the UK.

Please note that East Dorset and Purbeck Citizens Advice does not hold a sponsor
licence and, therefore, cannot issue certificates of sponsorship under the points-
based system.

Personal information and address for correspondence

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First name(s)

Last name

Address

Postcode

Telephone
home/work

Mobile

Email

We will normally contact you by email, however, if you would prefer to be
contacted using another method please let us know here:

Criminal convictions

Having a criminal record will not necessarily bar you from working for East Dorset
and Purbeck Citizens Advice – much will depend on the type of job you have
applied for and the background and circumstances of your offence.

For some posts, an offer of employment will be subject to a Disclosure and Barring
Service (DBS) check. If this applies to the post for which you are applying, this will
be noted in the application pack.

Please see Guidance Notes and Application Pack for further details.

Have you had any previous convictions not regarded as
spent under the Rehabilitation of Offenders Act 1974?

Yes  /  No

If YES please provide details of the offence and the date of conviction.

References

Please provide the names, addresses, telephone numbers and email addresses
of two people who may be approached for references. One of these should be
your present or most recent employer, the other could be someone who knows
you in a work related, voluntary or academic capacity. Both referees should be
able to comment on your suitability for the post applied for. References will only
be taken up for successful candidates following interview.

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Referee 1

Name

Address

Postcode

Telephone

Email
In which context does this
referee know you?

Referee 2

Name

Address

Postcode

Telephone

Email
In which context does this
referee know you?

Section 2

Information, experience, knowledge, skills and abilities

IMPORTANT INFORMATION

It is essential that you complete this section in full. Please refer to the
Guidance Notes for Applicants for further details.
● Please explain and demonstrate how your experience, skills and knowledge
meet the selection criteria in the Person Specification (found in the Job
Pack).

● Please ensure that you address

 ALL

 the criteria on the person specification

using the

 SAME ORDER AND NUMBER

  below.

1. Effective oral and written communication skills, including ability to

communicate appropriately with clients.

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2. Ordered approach to work and an ability and willingness to follow and

develop agreed procedures.

3. Ability to prioritise own work and  meet deadlines.

4. Ability to use IT and willingness to learn to use our case recording system.

5. Willingness to acquire the relevant knowledge through internal training.

6. Ability to give and receive feedback objectively and sensitively and a

willingness to challenge constructively.

7. Willingness to work as part of a team and ability to monitor and maintain

own standards

8.

 Understanding of and commitment to the aims and principles of the
Citizens Advice service and its equality and diversity policies.

Educational history

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Please give details of educational qualifications you have obtained from
school, college, university etc.

Subject

Level

Grade

Career history

Please include your current / previous employment (including job training

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schemes), voluntary work, community activities, school placements, time caring for
dependants etc. Please put in date order, starting with the most recent. (Continue
on a separate sheet if necessary.)

State position held and outline briefly the nature of the
work and your responsibilities.

Employer’s
name and
address and
type of
business.

Dates: From
Reasons for leaving:

Dates: From

Reasons for leaving:

Dates: From

Reasons for leaving:

To

To

To

Professional development
Please give details of any professional qualifications, including membership of any

professional bodies and any job-related training that you have undertaken.

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Declaration

Data Protection Statement: I consent to this information being processed and
stored for the purpose of recruitment and selection at East Dorset and Purbeck
Citizens Advice, and if appointed, for the purposes of employment at East Dorset
and Purbeck Citizens Advice.
I confirm that to the best of my knowledge, the information I have provided on this
application form is true and correct. I understand that if appointed on the basis of
false information contained in this form, I may be summarily dismissed.
If you are sending your application form by email, please mark this box ☐
(as a substitute for your signature) to confirm that you agree to the above
declaration.
Signed:

Dated:

Please return this form to:

Email address: office.hr@edpcitizensadvice.org.uk
Postal address:  Mill Lane, Wareham, BH20 4RA

If you require any reasonable adjustments to be made in the recruitment process or
at work subsequently if appointed, please make sure you tell us separately from this
form. We follow the social model of disability which believes that it is the barriers
created by society which disable people. We will use reasonable adjustments
wherever possible to remove those barriers.

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CONFIDENTIAL APPLICATION FORM
SECTION 3
Diversity monitoring

Please note this section will be detached before sending your application to the
recruitment panel for shortlisting.

Job title:

The Citizens Advice service is committed to valuing diversity and promoting equality.
We encourage and welcome applications from suitably qualified candidates from all
backgrounds regardless of age, disability, gender reassignment, marriage and civil
partnership, pregnancy and maternity, race, religion or belief, sex or sexual
orientation.

In order to achieve these aims we need to know about the diversity of people who
apply to work in the service. Please help us by providing the information requested
in the form below

Data protection overview

If you are happy to provide it, we will use this information for the sole purpose
of allowing us to monitor equality of opportunity and treatment as necessary
to maintain or promote equality within Citizens Advice in East Dorset &
Purbeck.

The information you give us will be kept securely, won't be shared outside the
service and is confidential.

It will not be seen by anyone responsible for making recruitment decisions or
have any impact on you directly.

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If you are successful in your application and we require this information for
other purposes, you will be asked to provide it separately - i.e. this form will
not be used for other purposes.

If you would prefer not to answer any of the questions we ask, please leave
them blank. If you would like us to stop using the information you provide,
please contact us.

Thank you for your co-operation.

The following information will not be seen by the recruitment panel and will
not affect your application.

Age
Which age bracket do you fit into? Put a cross in the relevant box.

Under 25

25 - 34

35 - 44

45 - 54

55 - 64

65 and over

Gender
What best describes your gender? Put a cross in the relevant box or write in a
preferred term.

Female

Male

I prefer to use another term

Please write in……………………………………...

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Sexual orientation
What is your sexual orientation? Put a cross in the relevant box or write in a
preferred term.

Heterosexual/Straight

Gay Man

Gay Woman/Lesbian

Bisexual

I prefer to use another term

Please write in……………………………………….

Ethnic origin

How would you describe yourself? Choose one section (A to E) and put a cross in the
relevant box within it.

A.  White

English/Welsh/Scottish/Northern
Irish/British

Irish

Gypsy or Traveller

Any other White background
Please write in……………………………………….

B.  Mixed/multiple
ethnic groups

White & Black Caribbean

White & Black African

White & Asian

Any other Mixed/multiple ethnic
background
Please write in……………………………………….

C.  Asian/Asian British

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian Background

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Please write in……………………………………….

D. Black/African/
Caribbean/Black British

African

Caribbean

Other Black/African/Caribbean
background
Please write in……………………………………….

E. Other ethnic group

Arab

Any other ethnic group
Please write in……………………………………….

Disability

A disabled person is defined under the Equality Act 2010 as someone with a
‘physical or mental impairment which has a substantial and long term
adverse effect on that person’s ability to carry out normal day-to-day
activities.’

Do you consider yourself to be disabled under the Equality Act 2010?

Yes

No

The information on this form is for monitoring purposes only. If you require any
reasonable adjustments to be made in the recruitment process or at work
subsequently if appointed, please make sure you tell us separately from this form. We
follow the social model of disability which believes that it is the barriers created by
society which disable people. We will use reasonable adjustments wherever possible
to remove those barriers.

Gender Identity
Is your gender identity the same as the gender you were assigned at birth? Put a
cross in the relevant box.

Yes

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No

Religion or belief

Which group below do you most identify with? Put a cross in the relevant box.

No religion

Christian (including all denominations)

Buddhist

Hindu

Jewish

Muslim

Sikh

Any other religion or belief

Please write in……………………………………….

How did you hear about this opportunity?

Please include details below:

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Trainee/Experience Admin Support - Energy Unit - Citizens Advice in East Dorset and Purbeck Ltd | Work In Charities