<p> Applicant Reference No. </p><p>Malvern Office Community Centre, 52 Prospect Close Malvern, Worcestershire WR14 2FD Telephone: 01684 312730 </p><p>Charity Registration No 703072</p><p>PRIVATE AND CONFIDENTIAL</p><p>Wellbeing Assistant</p><p>Please complete all sections in BLACK INK or typescript – a C.V will NOT be accepted. </p><p>When would you be able to start work? ...... </p><p>Where did you hear about this vacancy? ...... </p><p>Section One Personal Information</p><p>Name ...... </p><p>Address ...... </p><p>...... </p><p>Telephone no. (including area code)</p><p>Daytime:...... </p><p>Evening: ...... </p><p>Email: ...... </p><p>Your UK National Insurance Number...... </p><p>Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National?  Yes  No Applicant Reference No. </p><p>Additional Personal Information Preferred employment type  Full time  Part time  Job share  Secondment  Flexible hours</p><p>General</p><p> Do you have access to independent travel arrangements?  YES  NO</p><p>Do you have a current full driving licence?  YES  NO</p><p>Equal Opportunities Employer</p><p>Community First recognises the benefits of having a diverse workforce and therefore welcome applications from all sections of the community. In addition to this, under the provisions of the Equality Act 2010, all organisations are required to demonstrate that their recruitment processes are fair and that they are not discriminating against or disadvantaging anyone because of their age, disability, gender reassignment status, marriage or civil partnership status, pregnancy or maternity, race, religion or belief, sex or sexual orientation.</p><p>To encourage an equal opportunity policy, please specify if we need to make any particular arrangements for your interview:</p><p>------</p><p>------Applicant Reference No. </p><p>Section Two Work and Voluntary Experience </p><p>Please give details of your present and or most recent employment: Employer Name Start Leaving Job title and main responsibilities Reason for Leaving Date date</p><p>Please give information below about any other employment (paid or voluntary) and the necessary skills required or developed: Applicant Reference No. Employer Name Dates of Details of employment and skills required Reason for leaving employment Applicant Reference No. </p><p>Educational achievements</p><p>Educational Establishment Subject Qualification Date achieved Grade</p><p>NB: for qualifications relevant to the person specification and post, you will be expected to evidence your achievement at an interview Applicant Reference No. </p><p>Courses Course Name Start Finishing Detail of training programme Accreditations (if applicable) Date Date</p><p>Employment Gaps If you have any gaps within your employment history, please state the reasons for the gaps below.</p><p>Start Finishing Reason for career break Date Date Applicant Reference No. Section Three Additional Information</p><p>In this section we would like you to give your reasons for applying for this post. To give yourself the best opportunity please give examples below of the experience, skills and interests you would bring to this job, making sure you use the job description and person specification as a guideline. We do not discriminate on the basis of age and you, therefore, need not make any reference to dates. Continue on a maximum of 2 extra sheets of A4 paper if you wish. Please ensure that any additional sheets are numbered and include your applicant reference number and not your name in the top right hand corner. Applicant Reference No. </p><p>References</p><p>Please give the names, addresses and telephone numbers of two people who can be contacted for references. They will only be contacted if you are invited for an interview.</p><p>At least one should be your present / most recent employer.</p><p>1. Name ...... 2. Name ...... </p><p>Address ...... Address ...... </p><p>...... </p><p>...... </p><p>Telephone ...... Telephone ...... </p><p>Please state in what capacity you know each referee:</p><p>1...... 2 ...... </p><p>A report from your present employer may be required, but we shall not approach him/her without your permission.</p><p>May we approach them before the interview date? </p><p>Reference 1 YES / NO</p><p>Reference 2 YES / NO</p><p>DECLARATION</p><p>I confirm that to the best of my knowledge the information provided in this document is true and correct and can be treated as part of my subsequent contract of employment.</p><p>Signed: ...... Date: ...... </p><p>Please return the completed application form to: Alison Cartwright, Finance Officer & HR Administration Officer Community First Community Centre 52 Prospect Close Malvern WR14 2FD [email protected]</p><p>PLEASE MARK YOUR ENVELOPE “PRIVATE & CONFIDENTIAL”</p>