VACANCY DETAILS
Post applied for:
Where did you see this post advertised?
PERSONAL DETAILS
Surname:
Forename(s):
Forename known by:
Title:
Home address including postcode:
Telephone number:
Mobile
Nationality:
Do you hold a current driving licence and drive regularly?
YES/NO
HEALTH PROBLEMS, if any
Do you consider yourself to have a long-term disability or health problem which might affect your
ability to carry out the duties of your appointment? YES/NO
If ‘Yes’, please state the nature of the disability or problem and any relevant adjustment that you might
find helpful in the work environment:
EMPLOYMENT HISTORY
Name of Current Employer, if any:
Address of Employer
Post held:
Date appointed:
Brief description of your duties:
Present salary or rate of pay:
Notice period:
Previous employment: Please list all previous employment, starting with the most
recent (continue on separate sheet if necessary):
Dates (from/to)
Job Title
Employer
Reason for leaving
and final salary
RELEVANT VOLUNTARY EXPERIENCE:
Experience
Organisation
Dates (from/to)
EDUCATION AND TRAINING, from secondary school onward:
Name of school, college etc.
Qualifications gained/training undertaken
Dates (from/to)
MEMBERSHIP OF REGULATORY BODIES.
Please provide details of current memberships.
Name of Registration.
Date of Joining and renewal date
(from/to)
Membership no.
Please provide details of any
conditions which apply to your current
registrations
Please provide details of former memberships:
Name of Registration.
Date of Joining and renewal date
(from/to)
Membership no.
Please provide details of any
conditions which applied to your
former registration
Are you on any equivalent list in another UK jurisdiction?
REFERENCES: Please refer to the notes for guidance and give the names and
addresses of two relevant referees. At least one, and ideally both will be
employment referees and must include your present or last employer.
Name (and post title if applicable)
Full Address and telephone
number
Capacity in which
he/she has known you
1.
2.
May we approach your referee prior to interview?
YES/NO
YOUR EXPERIENCE AND ABILITIES:
Describe how your experience and abilities match the job requirements and what
you will bring to the team.
Tell us why you want to be The Lens Producer, and what you think the future could
look like for you in this role.
Signature
Date
Please note that providing false information or deliberate omissions may result in this
application being rejected or if you are successful, summarily dismissed.