PLAY ENGLAND
APPLICATION FORM
(Please expand the boxes as required)
Section 1 - PERSONAL DETAILS
Job applied for
First name
Title
Telephone
Address and post code
Preferred method of contact
Are you a UK citizen?
Job ref number
Surname
Email
Mobile
YES
NO
If not, do you have a
permit to work in the UK?
YES
NO
Section 2 - ELIGIBILITY TO WORK IN THE UNITED KINGDOM
To be considered for a role, you will need to have the right to work in the UK or have a valid UK work permit. You will be asked
to bring documentation under the immigration, Asylum and Nationality Act 2006 to support your right to work in the UK.
Section 3 - REFEREES
Please give the names of two employment referees, starting with your present or most recent employer. References are only
taken up after a provisional offer of employment has been made.
Name
Position
Company
Address
Telephone
Email
Name
Position
Company
Address
Telephone
Email
Section 4 - CURRENT EMPLOYMENT STATUS
Please confirm your current notice period and salary.
Notice Period
Current Salary (£)
Section 5 - DECLARATION
I declare that, to the best of my knowledge, the information given on this form is correct. I understand that providing
misleading or false information will disqualify me from appointment or, if appointed may result in my dismissal.
Signed
Date
Play England Registered Charity No 1150216. Company No 077880687
APPLICATION PACK
Since you are completing this form electronically you will be required to sign your application form if invited to interview.
PLEASE RETURN YOUR COMPLETED FORM TO:
Email:
[email protected]
Section 6 – EDUCATION
Please give details of education and qualifications including secondary, further and/or higher education, starting with your
most recent
Name of institution
Dates attended
Name of institution
Dates attended
Name of institution
Dates attended
Address
Qualifications and results
Address
Qualifications and results
Address
Qualifications and results
Section 7 - IT SKILLS
Please list the IT packages you use and your level of proficiency.
Package
Package
Package
Package
Package
Proficiency
Proficiency
Proficiency
Proficiency
Proficiency
Section 8 - TRAINING
Please list any training courses and any qualifications gained (if applicable)
Course title
Date attended
Qualification gained
Section 9 - PROFESSIONAL BODIES
Are you currently a member of any professional bodies? If yes, please state which body, your level of membership and
qualification gained.
Professional body
Level of membership/Qualification gained
Section 10 - EMPLOYMENT HISTORY
Please provide details of all jobs held including unpaid or voluntary work, starting with your current or most recent employer.
Name of Employer
Date from
Date to
Reason for Leaving
Job title held
Main responsibilities of role
Play England Registered Charity No 1150216. Company No 077880687
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APPLICATION PACK
Name of Employer
Date from
Date to
Reason for Leaving
Job title held
Date from
Date to
Reason for Leaving
Job title held
Main responsibilities of role
Name of Employer
Main responsibilities of role
Play England Registered Charity No 1150216. Company No 077880687
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APPLICATION PACK
Section 11 - COVERING STATEMENT
Outline any relevant skills, experience and training appropriate to the post you have applied for. YOU MUST relate your
application to the requirements set out in the person specification.
Person specification criteria
Evidence of skills, experience and training
Play England Registered Charity No 1150216. Company No 077880687
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APPLICATION PACK
Section 12 – EQUAL OPPORTUNITIES FORM
PLAY ENGLAND is fully committed to the active promotion of equality and diversity in its employment practices, in the work
that it undertakes and in the provision of all its services. PLAY ENGLAND treats all employees, service users and the children
and young people with whom we engage fairly, irrespective of their age, gender, sexual orientation, ethnicity, faith, disability
or impairment, including HIV status and mental health.
PLAY ENGLAND needs to record these details which will only be used to fulfill PLAY ENGLAND’s equal opportunities obligations
and as a guide in building efficient recruitment strategies. The information contained in this form is completely confidential.
1. Where did you hear about this position
2. What position are you applying for? (include job reference)
3. Your age range (please tick box)
16 – 21
22 – 30
31 – 40
4. Gender
Male
41 – 50
51 – 60
61 – 65
65+
Not stated
Female
5. How do you identify your ethnic group? Pleas tick the appropriate box or complete the section below
White UK
White Irish
White EU
White other
Black UK
Caribbean
African
Black other
Asian UK
Pakistani
Indian
Bangladeshi
Asian other
Mixed
Other (state)
6. Do you consider yourself to have a disability?
If ‘YES’ Please state the nature of the disability and whether
you need any adjustments to be made in order to be able to
carry out this role/interview at the best of your abilities.
YES
NO
PREFER NOT TO DISCLOSE INFORMATION
7. If you wish, you may disclose information about yourself in this section about your religion and sexual orientation
Religion
Sexual orientation
Date form completed
D
D
M
M
Y
Y
By completing this form I understand that I give my consent under the Data Protection Act 1998 for this information to be
processed in accordance with the PLAY ENGLAND policy for the purpose stated above.
Disclosure and Barring Service (DBS) Checks - If your application is successful and you are offered employment with us you may be asked
to consent to an Enhanced Disclosure check by the DBS. This is to ensure we safeguard the children and young people we work with. You
do not have to consent to these checks being carried out. However, if consent is withheld PLAY ENGLAND will have the right to withdraw
the offer of employment.
Data Protection Statement - The information that you provide on this form and that obtained from other relevant sources will be used to
process your application for employment. We may also use the information if there is a complaint or legal challenge relevant to this
recruitment process. We may check the information collected, with third parties or with other information held by us. We may also use or
pass to certain third parties information to prevent or detect crime, to protect public funds, or in other ways as permitted by law. By
signing the application form you are agreeing to the processing of sensitive personal data in accordance with our registration with the Data
Protection Commissioner.
Play England Registered Charity No 1150216. Company No 077880687
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