Application Form 2023
Application Form 2023
PART A
Personal details
Title:
Surname:
Forename:
Address:
Postcode:
Telephone:
(home and/or mobile)
E-Mail:
Criminal record
If you are successful in being offered a role at Beamish Museum we may request either a basic or
enhanced criminal record check, depending on the requirements of the role.
Do you currently have any ‘unspent’ convictions or cautions (including reprimands or warnings) that have
been issued by a Court in the UK or in any other country, or is there any action pending against you?
You need not declare convictions which are ‘spent’ under the Rehabilitation of Offenders Act (1974).
Please note these would show if an enhanced check were required for your role so you may wish to
declare in advance.
Employment History
Name and address of Job Title and main duties Date of departure and reason
employer(s) for leaving
Please state clearly how you meet all of the requirements listed on the job description. Please see the information to
candidates for advice on how best to complete this section.
Please note here the names, company (where applicable) and addresses of two persons from whom we may obtain
both work and character references
1. 2.
E-Mail: E-Mail:
Telephone No: Telephone No:
Can your references be contacted without any further authorisation from yourself?
Yes / No
Reasonable Adjustments
Do you require us to make any reasonable adjustments that will help you to demonstrate your full potential in the
recruitment process? If yes, please give details.
Declaration:
I confirm that the above information is complete and correct and that any untrue or misleading information will
give my employer the right to terminate any employment offered. I understand that any offer of employment is
subject to the company being satisfied with the results of a series of relevant checks including references, eligibility
to work in the UK, criminal convictions, probationary period and medical report (in line with the operation of the
Equality Act 2010).
Signed:
Date: