The N:Flame Trust

Sublime

36 Brigadier Hill

Enfield, Middlesex

EN2 0NQ

Tel: 0203 012 0059
Web: www.sublime.uk.com
E-mail:

Sublime Worker Application Form

We ask all prospective workers with children to complete this form. If there is insufficient room to answer any question, please continue on a separate sheet. Information provided will be kept confidentially by Sublime, unless requested by an appropriate authority.

Role(‘s) Applied for? ______

1b. Personal Details cont.

2. Christian Life & Experience

3. Working with Children/Young People – If applicable for role

4. Education

Please list academic, professional and other qualifications with dates and grades gained, including GCSE’s / O levels.

Subject/s / Grade/ level / Date / Where obtained

5. Employment Background

Please give details of your employment history – beginning with your present/ most recent job

Employer / Address / Position held / Dates

5. References

Please give the names, addresses and telephone numbers of two referees: (These will only be used if shortlisted).

Referee 1 ((Present / Most recent employer)

Name & Address ______

______

Tel No (day) ______Tel No (eve) ______E-mail ______

Referee 2 : (Present Pastor/ Church Leader/ Mentor)

Name & Address ______

______

Tel No (day) ______Tel No (eve) ______E-mail ______

Do you wish to be contracted before these references are taken up? Yes/No

6. Declaration

Because of the nature of the work for which you are volunteering it is exempt from the provision of section 4(ii) of the Rehabilitation of Offenders Act 1974 (Exemptions Order 1975), and you are therefore not entitled to withhold information about convictions which for other purposes are “spent” under the Provisions of the Act and in the event of an appointment, any failure to disclose such convictions could result in the termination of your contract with Sublime.

Charity No.: 1131280 Company No.: 06969145 V.A.T No.: 128 7979 56 Registered address: 69 Croyland Road , Edmonton, London N9 7BE