OF&G Quality Manual RD 169 Employment Application Form

Employment Application Form

Please return to Organic Farmers & Growers C.I.C.
Old Estate Yard, Shrewsbury Road, Albrighton, Shrewsbury, Shropshire, SY4 3AG

Guidance Notes
 Please type or complete this application form in black or dark blue ink and return with your
Curriculum Vitae (CV)
 We will decide whether to invite you for interview on the basis of the information given by you
on this Application Form.

Data Protection Act

 When you sign and return this form you are giving us permission to process and hold on
computer the information or data you have supplied or referred to on it, including any
information that you may consider to be sensitive and personal.
 This information will also be held on your personal file, if you are appointed
 The data may be used by Organic Farmers & Growers C.I.C. for the purposes of equality
monitoring, compiling statistics and maintaining other employment records.

Job Applied For

Job Title:

Closing Date: / / . Where did you hear about this job?

Personal Details (Block capitals please)

Surname First Name:

Home Address: Telephone: Day

Evening

Post Code: Do you have a full current driving licence?

Yes No (please delete as appropriate)

For Office Use Only

Appointed Yes No Qualifications Checked References Checked ID checked
and copied
Date and Signature: ………………………………
…………………………………………………………

Start Date:………......................... Reason for not

appointing…………...........................................................

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 ………………………………………………………………………………………………………….........................
.

Present Employment (if you are currently unemployed, please leave blank)

Job Title: Basic pay: £

Employer’s Name: Other pay: £

Date Started: / /

Address: Period of Notice:

Telephone Number:

Post Code: May we contact you on this number?

Yes No

Outline of duties and responsibilities:

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 If necessary, please continue on a separate sheet, placing your name in the TOP RIGHT corner
and numbering the additional sheets (Please use initials rather than first names)

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 Previous Employment – If full CV attached you do not have to
complete this section.
(Please list all of your previous jobs including any with your present employer. Start with the most
recent.) References may be sought from your previous employers.

Job Title: Date started: / /

Employer’s Name Date Left: / /

Address

Brief outline of duties:.

Reason for leaving:

Job Title: Date started: / /

Employer’s Name Date Left: / /

Address

Brief outline of duties:.

Reason for leaving:

Job Title: Date started: / /

Employer’s Name Date Left: / /

Address

Brief outline of duties:.

Reason for leaving:

If necessary, please continue on a separate sheet, placing your name in the TOP RIGHT corner
and numbering the additional sheets (Please use initials rather than first names)

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 Training and Professional Qualifications
Please list relevant job-related training you have undertaken over the last 2 years, and any
professional qualifications achieved. Start with the most recent.

Date Course Title Organiser Duration

Education and Qualifications

Please give details of secondary, further and higher education qualifications achieved. Start with
the most recent.

Date Qualification gained or pending & state Grade obtained Office use only:
Certs checked
subject and educational establishment Date & Sign

Membership of Professional Bodies

Date Professional Body Membership No, Grade/Level

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 Further Details
Please give any information which you think will help us to consider your application, including
relevant experience (voluntary or work), skills, abilities and any specialist knowledge you have.

Absence
How many periods of absences have you had through ill health in your last year of employment?

During that time, how many days in total have you been absent from work through ill health?
(please delete those that don’t apply).
0-3 days 4-10 days 11-20 days 21-29 days 30+ days

Please give brief details

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 Rehabilitation of Offenders Act 1974
Have you ever received a caution or been convicted by a court of any offence? (You may ignore
road traffic offences) delete as appropriate YES NO

If YES please give details including date, court and nature of offence:

References
Please give details of two referees whom we may ask about your suitability for the job. The first
reference must be your current or most recent employer (or school if you are a school leaver).
You should not name a relative as a referee. References will usually only be taken up if you are
selected for the post.

1) Name 2) Name
Address Address

Telephone: Telephone:
Occupation: Occupation:

May we contact these referees without asking you? 1) YES NO

2) YES NO
Any offer of appointment will be subject to receiving satisfactory references.

Your signature
I certify that to the best of my knowledge the details provided on this form and all other
supporting papers are true and correct. Furthermore, I understand that if I have provided false
information or misleading information in response to any questions on this form or have failed to
disclose information, this will result in the termination of any contract of employment entered
into, or the withdrawal of any offer of employment. I also hereby give my explicit consent to the
processing of data contained or referred to on this form, in accordance with the Data Protection
Act 1998 and any subsequent legislation.

Signature of Applicant:…………………………………………….. Date: / /

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