<p>APPLICATION FOR EMPLOYMENT</p><p>POST TITLE Ref No. CLOSING DATE</p><p>PERSONAL DETAILS</p><p>Title First Name(s) Surname M/F</p><p>Permanent Address Address for correspondence (if different)</p><p>Postcode Postcode</p><p>Daytime Telephone Number Evening Telephone Number</p><p>Mobile Telephone Number Are you holding a UK If NO, do you have a work passport or EU country visa? citizenship? YES / NO</p><p>YES / NO If YES, please state work permit number (you will be required to E-mail Address Do you have a clean driving produce this at an interview) licence?</p><p>YES / NO</p><p>PRESENT OR MOST RECENT EMPLOYMENT</p><p>Position held Salary</p><p>Name and address of present or most recent Starting date Leaving date / notice employer required Name</p><p>Name and telephone number of person who should Address be contacted for a reference</p><p>Postcode Tel No: May we take up your reference now? YES / NO</p><p>Reason for leaving</p><p>Brief description of duties</p><p>1</p><p>2</p><p>PREVIOUS EMPLOYMENT Please list all the organisations for which you have worked, starting with the most recent, using a continuation sheet if necessary</p><p>Name of Employer Position held Dates Main reasons for leaving From To</p><p>3</p><p>EDUCATION, TRAINING AND QUALIFICATIONS starting with the most recent</p><p>Name of university, college or school Dates Examinations taken, results and From To qualifications gained</p><p>SUPPORTING STATEMENT Please give details of how you consider your experience, knowledge, skills and personal qualities meet the requirements of the post as outlined in the job description and person specification, using a continuation sheet if necessary.</p><p>4</p><p>ADDITIONAL INFORMATION</p><p>Have you previously applied for employment, or been employed with the UJIA or associated charities? YES /NO</p><p>If yes, please give details:</p><p>SPECIALIST SKILLS</p><p>Please give details of any specialist skills or interests </p><p>HEALTH</p><p>So far as you are aware, are you suffering from any disease or disability that might affect your ability to perform the job for which you are applying? YES / NO</p><p>If yes, please give details:</p><p>How many days have you been ill in the past two years? ______</p><p>REFERENCES</p><p>REFERENCES Please give details of two people preferably former employers (other than present employer or relations) that may be contacted for a reference</p><p>Name Name</p><p>Address/email address Address/email address</p><p>Postcode Tel No: Postcode Tel No:</p><p>5</p><p>SECURITY REFERENCES For security purposes, we require personal references before visitors are allowed entry into the building. Please give names and contact details of anyone working at the UJIA who knows you, or a recognised person within the community, such as a rabbi or head teacher, or a former employer who knows you well and is able to confirm your identity. This person will only be contacted for verification if you are invited for an interview.</p><p>Name Name</p><p>Telephone number Telephone number</p><p>DECLARATION</p><p>I agree that employment with the United Jewish Israel Appeal is subject to satisfactory references and probationary period and that the information supplied by me on this form is correct and complete. I declare to the best of my knowledge, the information given is correct and I consent to it being held on file under the terms of the Data Protection Act 1998.</p><p>Signature______Date______</p><p>Please return the completed application form with a copy of your CV to:</p><p>Human Resources E-mail address: [email protected] UJIA 1 Torriano Mews Tel no: 020 7424 6400 Kentish Town London NW5 2RZ</p><p>6</p>