Full Name *
Full Name
Address *
Work Permit. Do you need a work permit to take up this post? *
Working in the UK. Are you eligible to work in the UK? *
Declaration If any item of information given on this form is subsequently found to be false, I understand this could result in the Termination, Summary dismissal or Variation of any offer of employment. I agree the company may approach my current/past employers for references*. I understand that completion of this form does not imply intent or obligation on the part of this organisation to provide employment. • I have completed all pages of this application form and the details I have supplied are, to the best of my knowledge, true and complete; • I understand that if appointed to this post the information on this form will be kept as part of my personal file record; • I understand that details of educational qualifications, membership of professional bodies and referee reports may be verified through the establishments and individuals I have indicated; • I consent to my details being kept confidentially and used for specific and lawful purposes as specified in the General Data Protection Regulation; • I declare that I have no previous convictions, or have identified any I have below.
As in accordance with the Rehabilitation of Offenders Act 1974 (Exclusions and Exceptions) (Scotland) Order 2013 all applicants to Birchwood Highland are not entitled to withhold information about convictions, which for other purposes of the Act are “spent”. Please declare any convictions in the space provided or write “none” as appropriate, then sign and date below.
Full Name of Organisation: Registration Number: Renewal Date:
Are you an existing member of the PVG scheme? *
Do you hold a full driving licence? *
From - To (Month/year) Institution (Name & Address) Title of Award/Subject (E.g. Highers/NVQ/SVQ/Degree etc.)
Subject Title of Award (e.g. Higher/NVQ/SVQ/Degree etc.) Grade Anticipated Date Anticipated
Job Title Employer Dates of Employment (From - To) Current Salary Notice Period Reason for Leaving
Start with your most recent employment first and work down the page. Job Title Employer Date From Date To
Please tell us your personal qualities, skills, attributes, experience and any major achievements and show how they match those needed for this job).
Your referees will include your present (or most recent) employer. Please identify below the person in your organisation who is authorised to confirm your employment and the details given in your application. Please identify a second referee who may have closer knowledge of your skills, knowledge and abilities and who may offer opinion on your suitability for this post. You should not use family members or friends. Our pre-employment screening also includes, where appropriate, health and fitness for work, criminal records, qualifications and professional registration. Note that references will only be taken up for Preferred Candidates following interview.
Referee 1 Full Name *
Referee 1 Full Name
Referee 2 Full Name *
Referee 2 Full Name
This form will be detached from your application and will be used solely for monitoring purposes. Birchwood Highland recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections of the community.
Please identify your ethnicity below *
The Disability Discrimination Act 1995 defines disability as “A physical or mental impairment, which has a substantial and long-term effect on the person’s ability to carry out normal day-to-day activities”.
Which of these best describes your sexual orientation?
Thank you for taking the time to complete this questionnaire.