Job Application Form

West Wiltshire District Council

Job Application Form (Confidential)

Your email address: 

Application for the post of : 

Post Ref:     Closing date:    

Department: 

SECTION A - EDUCATION &QUALIFICATIONS 

Secondary Education

Qualification(s):                    Subject(s):              Grade(s):

Further and Higher Education        

Qualification(s):                    Subject(s):              Grade(s):

SECTION B - MEMBERSHIP OF PROFESSIONAL INSTITUTIONS

Technical or professional qualification/ membership (including membership of professional bodies)

Qualification/      Subject:   Length of qualification/        Grade/
membership:                         membership:                          level:

SECTION C - COMPUTER SKILLS 

Indicate the computer packages that you are currently able to use to complete tasks from the options below:

Excel    Word   Access    E-Mail    PowerPoint

Provide details of any other systems that you can use and / or computer qualifications that you have attained

SECTION D - EMPLOYMENT/ WORK EXPERIENCE

Current Employer    From - To 

 
Job Title
Salary Reason for leaving
Previous Employer(s)   (Please begin with the most recent)
Employer 1 From - To

 
Job Title
Salary Reason for leaving
Employer 2  From - To

 
Job Title
Salary Reason for leaving
Employer 3  From - To

 
Job Title
Salary Reason for leaving
Employer 4  From - To

 
Job Title
Salary Reason for leaving

SECTION E - ADDITIONAL INFORMATION

Please provide details of your hobbies and interests if they are relevant to the position you are applying for

SECTION F - CURRENT DUTIES

Please provide details of your current duties

SECTION G - OTHER RELEVANT INFORMATION

The information you provide will be used in assessing your application. Please set out in this section how you meet the various criteria shown on the enclosed person specification and any other relevant information that supports your application.

Please do not use a CV.

SECTION H - REFERENCES

Please provide the names and addresses of two referees (not relatives), one must be your present or most recent employer and the other must have known you for at least 3 years.
Referee A Referee B
Full Name Full Name
Occupation Occupation
Full Postal Address Full Postal Address
Telephone Number Telephone Number
E-Mail E-Mail
In what capacity is this person known to you? In what capacity is this person known to you?
If invited for interview, may we contact the above referees before the interview takes place? 
Referee A   Referee B  
Yes   No  Yes    No

SECTION I - OTHER INFORMATION

The Council requires any candidate for appointment as an officer to state in writing whether they are a parent, grandparent, partner, child, stepchild, adopted child, grandchild, brother, sister, uncle, aunt, nephew or niece of an existing Councillor or officer of the Council. 

If you are related to a Councillor or Officer, please provide the following details:  

Name Relationship
..

The Council will disqualify any applicant who directly or indirectly seeks the support of any Councillor for any appointment with the Council.

Are you an elected member of a Local Authority?    Yes         No  

Have you been nominated as a candidate in a forthcoming Local Authority Election?     Yes         No  

Equal Opportunities in Employment

West Wiltshire District Council is committed to an Equal Opportunities Policy (link opens in new window) in Employment. The aim of our policy is to take into account only the suitability of the individual concerned and ensure that no job applicant receives less favourable treatment on the grounds of race, colour, nationality, ethnic or national origins, disability, religion, age, sex, marital status or sexual orientation, or is disadvantaged by conditions or requirements which cannot be shown to be justified.

To assist in ensuring the effectiveness of the policy, all applicants are asked to provide the following information that will be used for confidential monitoring purposes and will be separated from your application. The information that you provide here is held in the strictest confidence.   

Title:           Mrs      Miss        Ms       Mr         Other:

Surname: 

Forename(s):

Address: Telephone Number(s):
Work
Home
Mobile

Date of Birth:

Gender:  

Marital Status:  

Disability Discrimination Act 1995

Do you have an impairment that comes under the Disability Discrimination Act 1995? (A definition of terms in the act is available here (link opens in new window).

Yes     No 

Do you have any special requirements if you are asked to attend an interview at these offices?

Yes     No  

If yes, please state how we can help you:

 

Nationality 

Do you require a work permit to work in the United Kingdom?

Yes     No

Ethnic Group

I would describe my ethnic group as:

White Chinese or other ethnic group  Asian or Asian British
British   Chinese Indian
Irish Any Other  Pakistani
Other white background (please specify)  (please specify)   Bangladeshi
Other Asian background
 (please specify) 
b>Black or Black British Mixed Gypsies and Travellers
Caribbean White & Black Caribbean Romany Gypsy
African White & Black African Irish Traveller
Other black background White & Asian Scottish Traveller
(please specify)  Other mixed background (please specify)  Other Gypsy or Traveller Group (please specify)

Criminal Convictions

Please give details of any Criminal Convictions. Convictions which are "spent" under the Rehabilitation of Offenders Act 1974 (link opens in new window) need not be disclosed.  If you have an unspent conviction please provide further details:

Conviction: 

Sentence:   

Date: 

Please note, if you are selected for a post with substantial access to children, vulnerable adults or a position which is classed as exempt under the Rehabilitation of Offenders Act 1974, the Council will require you to give permission to carry out a check with the Criminal Records Bureau to establish whether or not you have a criminal background. Please refer to our "Employment of ex-offenders policy" for further details. If the Council deems that a check is relevant and necessary for the position you are applying for, a statement to this effect will be contained in the recruitment pack.

Notice

Notice required by present employer:    

Driving Licence

Please state the type of driving licence held:
None
Provisional
Full
Do you have use of a motor vehicle?
Yes         No
Lease Car?
Yes         No   

From what source did you learn of this vacancy? Please provide the full name of the Newspaper or Professional Magazine if applicable. 

Declaration by Applicant

I confirm that the information given is correct, that I have not canvassed any elected member of senior officer of West Wiltshire District Council in relation to this appointment and understand that misleading statements or deliberate omissions may be sufficient grounds for cancelling any agreement made. 

Please tick here to confirm declaration 

You will be asked to sign a copy of this form if invited for interview. 

This completes the online application form.

  

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