Application for Employment Confidential

This form must be completed in full by all candidates in black ink pen or typescript.

Job applied for: Housing Officer Closing date: 4 August 2017 midday Email: [email protected]

1 Personal information Surname: Forenames:

Known as: Permanent Address:

Contact details: Home: Work: Mobile: E-mail address:

2 References Two referees are required. One of these should be your present, or most recent employer. These will not be contacted until after the interview. Present/most recent employer Second referee Name: Name: Address: Address:

E-mail address: E-mail address: Telephone number: Telephone number: Capacity in which known to you: Capacity in which known to you:

3 Education Please give here relevant details of education and qualifications including current/proposed courses. Schools/College/Universities Dates Qualification(s) with dates 4 Other training Please give details of other training undertaken and any membership of professional associations. 5. Employment 5.1 Present or most recent post (paid or unpaid) Job Title: Salary: Name and address of present or most recent employer:

Reporting to: Date started: Date of leaving: (if applicable) Reason for leaving:

Please give a brief description of duties and responsibilities: 5.2 Previous Posts Please list all previous employment, starting with the post held immediately before the post described above: Job title and name and From To Brief description of main address of employer Month Year Month Year responsibilities 6 Supporting statement Please make full use of this section to give further information, addressing the points listed in the job description and person specification, including why you want to apply for this post; how your skills and experience match the requirements of the position; and any other details of interests/voluntary work relevant to the post. This should be a maximum length of two sides of A4. 7 Additional information Are there any dates when you would be unavailable for interview?

Do you need a work permit to work in the UK? YES/NO If yes please specify:

If appointed when could you start?

How did you find out about this vacancy?

8 Declaration:

I declare that the information provided on this form, and on any accompanying documents, is true to the best of my knowledge and belief. I understand that false information may lead to the termination of employment or withdrawal of a job offer.

I agree that the content of this form and of any accompanying documents may be treated as part of any Contract of Employment agreed between myself and Bahay Kubo HA Ltd.

Signed:...... ………………...……………

Date:...... ….....…………………

Please return this form in an envelope marked "Confidential" to:

Bahay Kubo H.A. Ltd Unit 1 Fountayne Business Centre Broad Lane, South Tottenham London N15 4AG Equal Opportunities Monitoring Form Confidential In order to ensure that Bahay Kubo HA Ltd. continues to develop its commitment to equal opportunities, all job applicants are asked to answer the questions below. This information will be treated as confidential, and used solely for monitoring purposes. The form will be separated from the application form on receipt before short-listing of candidates takes place. The selection panel will not see this form. If you prefer not to disclose any of this information, please leave the section(s) blank Post applied for: How did you find out about this vacancy? (please tick one box only) National Press Leaflet / Flyer / Email shot Local Press Friends in the community Other (please describe) I would describe my ethnic origin as (please tick one box only) Please tick this box if you would prefer not to answer this question: White Asian or Asian British British Indian Irish Pakistani Any other white background Bangladeshi (please describe) Any other Asian background Mixed (please describe) White & Black Caribbean Black or Black British White & Black African Caribbean White & Asian African Any other mixed background Any other Black background (please describe) (please describe) Filipino or other ethnic group Filipino Any other background (please describe) Please describe your religious group Please tick this box if you would prefer not to answer this question:

How would you describe your sexual orientation? Please tick this box if you would prefer not to answer this question: Heterosexual Lesbian Gay Bisexual Other (please describe) Please indicate your age and gender Male Female Age Date of Birth Health Please indicate the number of days taken as sick leave from work in the last two years: Please give reasons for such absences:

Have you had any hospital treatment in the last five years? YES/NO If YES please give details:

Do you consider yourself to have a disability? YES/NO If YES please give details:

Do you have any other health problem, which limits your daily activities or YES/NO the work you can do? If YES please give details:

May we ask your GP for a medical reference before offering employment? YES/NO Would you be willing to be medically examined at Bahay Kubo’s expense? YES/NO