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Please complete this form in black ink or typescript.Continue on the back of this form or a separate sheet if necessary.
Position applied for: Dance Practitioner
Personal Details
Surname (Block letters):
Forename(s):
Date of birth:
Telephone number:
Mobile number:
Address:
Email address:
Full Clean Driving Licence? Yes / No Do you have daily access to a car for business use? Yes / No
Where did you see this post advertised?
FOR OFFICE USE ONLY
INTERVIEW DATE TIME
CONFIRMED REFERENCES REQUESTED REFERENCE RECEIVED
APPOINTMENT OFFERED
STARTING SALARY START DATE
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 1
Previous employment (most recent position first)
Employer & Post From: To: Salary:
Brief outline of duties
Reason for leaving Period of notice
Employer & Post From: To: Salary:
Brief outline of duties
Reason for leaving
Employer & Post From: To: Salary:
Brief outline of duties
Reason for leaving
Continue on a separate sheet if necessary
Professional qualifications and training
Dates Organisation Qualification
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 2
EducationIn chronological order – most recent first
From To School/College/University Qualifications (please state subject and grade)
Do you have any special access requirements?
YES / NO
If YES, please give brief details:
ReferencesPlease give names, addresses and occupations of at least two persons to whom reference may be made. Please state your relationship with referees; at least one must be your present employer.
Name: Name:
Relationship: Relationship:
Email address: Email address:
Address: Address:
May we approach your present employer for a reference before interview? YES / NO
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 3
Statement in support of application – please use this space to state your reasons for applying for the post, relating your skill, experiences and personal qualities to the job requirements. Please pay particular attention to our Guiding Principles when writing your statement (continue on a separate sheet if required):
I declare that the statements made by me are true to the best of my knowledge.
Signature Date
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 4
Disclosure of Information for people working with children and vulnerable people
TIN Arts Limited, as an organisation, uses the Disclosure and Barring Service to access applicant’s suitability for positions of trust. A request for information may be made in the event of a successful application.
However, a criminal record will not necessarily be a bar to obtaining a position. A written policy on a) the recruitment of ex-offenders, and b) the secure storage, handling, use, retention and disposal of disclosure information, plus the code of practice on information about disclosures are available upon request.
Signed: ............................................................
Date: ...............................................
Please return to TIN Arts at the address shown below by the closing date.
Forms to be returned/emailed to:
Claire DeftyOperations LeadTIN Arts LimitedOld School HouseFront StreetFramwellgate MoorDurhamDH1 5BLTel: 0191 3840728
Email: [email protected]
Deadline for applications: 12 noon on Monday 22nd September 2014
Practical interviews will be held on Wednesday 1st October 2014
If you are successful in securing an interview, you will be notified by Wednesday 24th September 2014.
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 5
Equal Opportunities
You do not have to give us the following information but we would be very grateful if you would answer the questions below. Any information provided may be used for monitoring and reporting. We will not use this information to assess your application.
1. Please mark the box that best represents you.
WhiteBritish
Irish
Asian or Asian British
Asian Bangladeshi
Asian Indian
Asian Pakistani
Any other Asian background
Black or Black British
Black African
Black Caribbean
Any other Black background
Chinese
Asian and White
Black African and White
Black Caribbean and White
Chinese and White
Any other background from more that one ethnic group
Any other ethnic group (please give details)
2. Do you consider yourself to be disabled?
Yes No
D a n c e P r a c ti ti o n e r A p p l i c a ti o n F o r m , A u g 2 0 1 4 P a g e | 6