Wigan Link - a Not For Profit Company providing a service to individuals, who have a learning disability

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Job Title

As Advertised in

Surname

First Name

Address (Correspondence)

Telephone Number

Date of Birth

Age

Please give details of present positions with brief description of duties.

Employer

Job Title

Salary

Date of Appointment

Notice Period

Main Duties and Responsibilities :

Previous appointments. Also include any activities, not necessarily employment, where skills and experience were gained (e.g., voluntary work). Please give any Specific job related training e.g., NVQ

Employer / Agency

Dates

Posts Held

General Education Please state qualifications, subjects, grades and dates.

Qualifications e.g., Professional and Vocational

References:
Please supply names and addresses, telephone numbers and occupations of three people who are willing to give you a reference. At least one of these must be from your current or most recent employer. Preferably all referees should be qualified to comment in relation to the job description.

Can these references be taken up immediately?

	Yes	No
Ref No.1

	Yes	No
Ref No.2

	Yes	No
Ref No.3

Do you hold a full driving license and are not currently disqualified from driving?

Do you hold a full driving license and are not currently disqualified from driving?	Yes	No

Experience and reasons for applying for this post.

10.

Due to the nature of the work for which you are applying, this post is exempt from The REHABILITATION OF OFFENDERS ACT 1974 by virtue of the Rehabilitation of Offenders Act 1974 (exemptions) order 1975. You are required to disclose any information you may have regarding any convictions against yourself which you may otherwise consider ‘spent’ in relation to this application. Any such information will be treated in the strictest confidence and used only in consideration of the suitability of your application.

This post is subject to a full CRB enhanced disclosure.

Have you ever been convicted of any criminal offences?	Yes	No
Have you ever been convicted of any criminal offences?

If yes please give details.

11.

Medical Declaration:

Are you fit to carry out the work as defined in the job description and person specification?

Yes

How many periods of sickness have you taken from work in the last two years?

Do you have and illness or medical conditions that we should know about?

Information for applicants.

You will receive no further information unless you have been selected for interview. If you have not been contacted within two weeks of the closing date, you must conclude that you have been unsuccessful. If yo require acknowledgement of receipt please enclose a stamped addressed envelope.
All offers of employment will be subject to references that are satisfactory to Wigan Link. At least one of these must be from your current or most recent employer. Also a full clear ENHANCED CRIMINAL DISCLOSURE.
Wigan Link strives towards being an Equal Opportunities Employer.

Thank you for the interest you have shown in this position.

12.

To the best of my knowledge and belief all the particulars I have given are true.

I understand that any false statements may disqualify me from employment or render me liable for dismissal. I also understand that no offer of employment to me will be binding unless confirmed in writing.

Wigan Link Office 5 & 10, Hindley Business Centre, Platt Lane Hindley, Wigan, WN2 3PA
Tel: 01942 - 202054 Fax: 01942 - 732596 Email: Norman@wiganlink.co.uk