‘Working in Partnership’

Job Application Form (please write clearly in Black ink or type)

Employer - Ref:
Position -

PERSONAL DETAILS (BLOCK CAPITALS PLEASE) (This section must be completed in full)
Surname:
Surname: Forenames:
(Mr/Mrs/Ms/Miss)
Address: Tel No:
Mobile No:
National Insurance Number:
Source: Jobcentre □ Web □ Community Organisation □
Post Code: Other: (Please specify) ……………………………….
Are you registered with Glasgow East Regeneration
Agency: Yes □ No □

EDUCATION & PROFESSIONAL QUALIFICATIONS

(ORIGINAL DOCUMENTS AS PROOF OF QUALIFICATION MAY BE REQUIRED AT INTERVIEW)

Secondary Schools; Dates Examinations taken Date Result

College; University

From To

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
PRESENT POST

Title of Post: Salary:

Name & Address of Employer: Business of
Employer
Date
Commenced:
Date ended
(if applicable)
Please outline your responsibilities, to whom you are responsible and staff responsible to you (if applicable)

Reason for leaving or wishing to leave:

Period of notice required to terminate present employment:

PREVIOUS EMPLOYMENT

Name & Address of Position held Dates Reason for leaving and final
Employers grade/salary
From To

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
RELEVANT EXPERIENCE

Please say why you are applying for this post, outline aspects of your experience and give details of any
particular achievements or distinctions which you consider relevant to this application. Please use a continuation
sheet if necessary.

OTHER INFORMATION
Glasgow East Regeneration Agency – http://www.gera.org.uk
May ‘08
What activities outside work interest you? (State any positions held you consider relevant)

Do you hold a current driving licence? YES/NO Do you own a car? YES/NO

DISABILITY DISCRIMINATION ACT 1995

Are there any adjustments which you think we could make to overcome a disability in relation to the essential
requirements of this job? YES/NO
If Yes, please provide further details (use a continuation sheet if necessary):

REHABILITATION OF OFFENDERS ACT 1974 Please note: If the post you have applied for meets the exemption
requirements under this Act, all applicants who are offered employment will be subject to a criminal record check before the
appointment is confirmed. This will include all spent convictions, cautions, reprimands or final warnings. (See information
sheet for further guidance)

Please declare any unspent convictions (or all convictions if the post is exempt) on a separate sheet and tick this box if doing
so

REFERENCES

Names and addresses of two referees, one of whom should be your current or most recent employer (if applicable):

Tel No: Tel No:

Email Address: Email Address:
Please indicate if we may contact them prior to interview YES/NO

DECLARATION

I declare that the information given is true and correct. I give my consent to my referees being contacted as indicated and for details of
any sickness absence over the last 2 years to be obtained.
Signed …………………………………… Date ……………………..……Name ………………………………………

Thank you for completing this application. Please return to: Data Protection Act 1998
The use of information provided on this form will comply
Recruitment Team with the requirements of the above Act. It may be processed
by computer and is required for operational, managerial
Glasgow East Regeneration Agency
information and associated purposes relevant to the
Westwood Business Centre maintenance of the Department’s systems. Such data may
69 Aberdalgie Road also be used to produce depersonalised statistics.
Glasgow
G34 9HJ

or email jobs@gera.org.uk
Phone Number - 0141 781 2033

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
 Glasgow East Regeneration Agency
Diversity Monitoring Form In Confidence

We are an equal opportunity employer. The aim of our policy is to ensure that no job applicant
or employee receives less favourable treatment on the grounds of race, colour, creed,
nationality, ethnic or national origin, religious belief, age, political opinion or affiliation, sex,
marital status, sexual orientation or disability, or is disadvantaged by conditions or
requirements which cannot be shown to be justifiable.

Our Selection Criteria and procedures are frequently reviewed to ensure that individuals are
selected, and treated on the basis of their relevant merits and abilities. All applicants are given
equal opportunity.

We are committed to an ongoing programme of action to make this policy fully effective. To
ensure that this policy is fully and fairly implemented and monitored, and for no other reason,
would you please provide the following information:-

Company / Post Applied For: ……………………................

PERSONAL DETAILS:

Name: …………………………………………………………..

Please tick the appropriate boxes to indicate you sex and marital status:

Female □ Married □ Single □

Male □ Divorced □ Separated □

What age group do you fall under and date of birth:

16-18 □ 19-24 □ 25-39 □ 40 -59 □ 60 and over □ Date

of Birth: …………………

National Insurance Number: ……………………………………

Do you consider yourself to be:

Disabled □ Not Disabled □

If you consider yourself disabled please state the nature of your disability:

……………………………………………………………………………………...

Please indicate if you have any of the following:

Sensory Impairment Yes □ No □

Learning Disability Yes □ No □
Physical Disability Yes □ No □
Mental Health Condition Yes □ No □

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
Do you consider yourself to have:

Addiction Problems
Yes □ No □

Physical Health Problems

Yes □ No □

Non-physical Health Problems

Yes □ No □

Ethnic Origin

I would describe my ethnic origin as: - (please tick)

White
Scottish □ Other British □ Irish □ Any other white background, please write in:
…………………………..…

Mixed
Any mixed background, please write in ………………………………………………………………….
…………………

Asian, Asian Scottish, or Asian British:

Indian □ Pakistani □ Bangladeshi □ Chinese □
Any other Asian background, please write in: ……………………..

Black, Black Scottish or Black British:

Caribbean □ African □ Any other Black background, please write in:
……………………………………………

Other Ethnic Background

Any other ethnic background, please write in: …………………………………………….
……………………………….

Benefit Group

Incapacity Benefit □ Over 50 □ JSA(claiming 6+ months) □ Lone Parent

with Benefit □
MCMC with Benefit □ (More Choices More Chances ) BME with Benefit □ (Black Minority Ethnic)

Other Benefit □ ………………………………………. Not Claiming Benefit □

Length of unemployment :

0-6mths □ 6-12mths □ 12-18mths □ 18mths – 3yrs □ 3yrs plus □

Does Not Apply □

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
Glasgow East Regeneration Agency is committed to using all reasonable endeavours to ensure
compliance with the requirements of the Data Protection Act 1998 and maintain confidentiality in all our
dealings with you.

The Data Protection Act 1998 sets out rules for processing personal information and applies to paper and
digital records, covering collection, storage, processing and distribution of personal data, and giving certain
rights to individuals.

Glasgow East Regeneration Agency will use the information that you provide to assist you to access the
services we offer. In order to provide access to these services we may need to forward your information to
other service providers, such as Community Planning Partnership, Scottish Enterprise, Glasgow City
Council, Job Centre Plus or other such service providers who may be able to assist.
All confidential information (whether recorded in writing or by other means or given orally without record)
you disclose in connection with the services we will provide will be subject to the following conditions:

a) we will take all proper and reasonable measures to ensure that the confidentiality of such
information is maintained;
b) we will not use the information for any promotional purposes without obtaining signed consent via
a Media Release Form;
c) we will not disclose the information to any third party without written permission;
d) we will not disclose the information to employees other than necessary to provide assistance and
access to our services;

Information provided by you will only be shared with other organisations who comply with the Data
Protection Act 1998, and will only be provided to allow them to assist you.
Glasgow East Regeneration Agency will use the information you provide for monitoring and evaluation
purposes.

The records we hold relating to you can be accessed at a mutually convenient time by submitting a written
request.

I agree to my personal details being used as described above.

Signature:

Date:

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
GLASGOW EAST REGENERATION AGENCY – RECRUITMENT
SERVICES

COMPLETING THE APPLICATION FORM – NOTES FOR

APPLICANTS
GENERAL

 Please complete the application form in either blue or black ink.

 Ensure that when you complete the application form your writing is
legible. If you prefer, please complete the form in block capitals.
 If you require further space when completing any section of the
application form, please feel free to use additional sheets of A4 paper.
However, please ensure that any extra sheets of paper are attached
securely to your application form.
 Before returning your fully completed application form, it is useful to
take a copy of it in case you are invited for an interview.
 Return your fully completed application form to; The Recruitment Team,
Glasgow East Regeneration Agency, Westwood Business Centre, 69
Aberdalgie Road, Glasgow, G34 9HJ.
 If you do have any questions when completing your application form
that are not answered here, please contact us on 0141 781 2033.

POSITION APPLIED FOR

 Please state the title of position and company name you are applying
for.

PERSONAL DETAILS

 Please ensure that you insert at least one contact telephone number in
order that you can be easily contacted for interview purpose.

EMPLOYMENT HISTORY

 Starting with your most recent or current position, please complete the
section with your employment details.

NB Don’t worry if you don’t fill in all of the section. Alternatively, if you
require further space, please go on to an extra sheet of A4 paper.

Please include any periods of work experience undertaken.

FURTHER INFORMATION

 These three questions are a real opportunity to help sell yourself, so

please think carefully about your answers before you put pen to paper.
If you require further space, please go on to a separate sheet of A4
paper.

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08
CRIMINAL OFFENCES

For positions Glasgow East Regeneration advertise, unspent convictions need

to be disclosed on your application form.

PERMISSION TO WORK IN THE UK

 We are not allowed to employ any individuals who are unable to provide
one of the documents listed on the application form, so please clearly
indicate which of these documents you possess.
 As part of the recruitment process you will be asked to produce the
original of one of these documents.

NB If you are unable to provide us with evidence that your have the right to
work in the UK, then we will not be able to offer you a position.

REFERENCES

 Please ensure that you provide the name and contact details of two
referees.
 If this is not your first job, please make one of the referees your current
of last employer.
 If this is your first job, please ensure that one of the referees you give is
a teacher/tutor from your last educational establishment.

DECLARATION

 Please ensure that you sign your application form.

 Under the Data Protection Act 1998, it is required that all individuals
must give their consent so that Glasgow East Regeneration Agency are
to able to process any data that relates to that individual.

Glasgow East Regeneration Agency – http://www.gera.org.uk

May ‘08