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Personal information

Current or most recent employment


Please give details of two employers who can provide us with a reference, one of whom must be your current or most recent employer. In the case of a first appointment, one referee should be from your school or college. You should only give personal references if employment references are not available.

Reference 1
Reference 2

If you are shortlisted for this role, do you have any objections to us contacting your referees before interview?

Previous employment

Please list the most recent first.

If you have had any breaks in your employment, please give details of these periods and your activities during these times (for example, unemployment, voluntary work, training and so on).

Education, training and qualifications

Education Please include any qualifications, training and current membership of professional associations that are relevant to the post.

Impairment and disability

Do you consider yourself to have a physical, learning, sensory or mental health impairment or disability?

If 'Yes' do you require any adjustments to enable you to apply or attend interview. Please state any adjustments required.

Extra information

Please answer the following questions only if the person specification for the post includes these requirements.

Personal statement

Please tell us how your knowledge, skills and experiences match the requirements of the job role.


I confirm that the information I have given on this form is true and correct, and you can treat it as part of any future contract of employment. I understand that if I do not provide complete and correct information, you may withdraw an offer of employment or, if I am already employed, dismiss me immediately. I also give you permission to use my personal information for monitoring and management purposes.

I understand that you will deal with all the information in line with the data protection legislation.

Please provide your full name
Please provide your valid email address

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