Personal Details: (Private and Confidential)
Personal Details: (Private and Confidential)
Personal Details: (Private and Confidential)
PERSONAL DETAILS
(PRIVATE AND CONFIDENTIAL)
Job title:
Closing date:
Personal Details This information is detached prior to your application being considered
Title
First name(s)
Address
Surname
Preferred Name
Email address
Preferred method of
contact:
Telephone
Mobile
Postcode
Date of birth
E-mail
Phone
Post
Gender
No
If Yes and there are conditions attached, e.g. start and finish dates, please specify:
If No what type of work permit do you require?
References Please provide an email address as first point of contact for referees
Name
Position/occupation
Address
Email
Relationship
Length of time you have known this person
Postcode
May we contact this person prior to interview? Yes
No
Name
Position/occupation
Address
Email
Relationship
Length of time you have known this person
Postcode
May we contact this person prior to interview? Yes
No
Name
Position/occupation
Address
Email
Relationship
Length of time you have known this person
Postcode
May we contact this person prior to interview? Yes
No
Disability
Do you consider yourself to have a disability? Yes
No
If Yes please state the nature of the disability. Would you need any adjustments to be made to
allow you to successfully perform this role?
Do you need any special assistance in attending interview? If so, please give details:
The Disability Discrimination Act 1995 defines a disability as a physical or mental impairment which
has a substantial and long term adverse effect on your ability to carry out normal day to day activities.
No
White
White British
White Irish
Gypsy or Irish
Traveller
Any other White
background
Mixed
Mixed White &
Black Carribbean
Mixed White &
Black African
Mixed White &
Asian
Any other Mixed
background
Chinese or other
ethnic group
Chinese
Any other ethnic
group
Please specify
Sexual Orientation
Heterosexual
Homosexual
Bisexual
Other
Religion
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
No religion
Other
Medical Information Please comment on your current health status if you feel this would be
helpful:
In accordance with the Data Protection Act 1998, the information provided on this form will be
used in the recruitment and selection process and may be disclosed to those who need to see it.
It will also form the basis of the confidential HR record of the candidate. In the case of
unsuccessful candidates, the Personal Details and Application Form will be destroyed after 6
months.
I hereby declare that to the best of my knowledge, all the information given by me is correct and
that I possess all the qualifications I have listed on this form. I agree that the Theatre Royal
Plymouth Ltd ha the right to validate any of the information provided.
I understand that any false statements could results in my dismissal, if appointed.
Signed:
Date
APPLICATION FORM
Please refer to our guidance notes before completing in blue or black ink
Employment History
Please provide information on your most relevant employment, starting with the most recent
Employer
Job title
Start
date
End
date
Dates employed
Job title
Notice period
Summary of duties
Rate of
pay
Employer
Dates employed
Job title
Notice period
Summary of duties
Subject
Attainment level
or result
Professional membership
Date
Date
gained
Do you have any other work commitments, either paid or unpaid, which you would wish to
continue with if offered employment?
Yes
No
Supporting Statement
Please use this space to state your reasons for applying for the post, relating your skills,
experiences and personal qualities to the job requirements.
Meets
Please
tick
Comments/feedback
A=ALL
B=MOST
C=SOME
D=NONE
Invite
interview
to
No
Yes
No
____________________
No