Apply for a job STRICTLY CONFIDENTIAL. E-mail: humanresources@rcdow.org.uk 1Applicant Details2Statement3Employment History4Education5Additional Information6References7Declaration Post Applied For* Location of Post* Diocesan job reference* Where did you see this job advertised? Name* Title Mr.Mrs.Ms.MissRev.Dr. First Middle Last Address* Street Address Town County/Region Post Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Mobile*Other PhoneEmail* Statement in support of your applicationWhy does this job interest you? How do you meet each of the essential criteria in the Job Description?Statement UploadAlternatively you can upload a statement. DO NOT upload your CV please.Accepted file types: pdf, doc, docx, txt, , Max. file size: 2 MB. Current or most recent employerPlease provide employment history for the last 10 years starting with the most recent. Please explain any employment gaps below.Employer's Name and address* Start Date* DD slash MM slash YYYY End Date DD slash MM slash YYYY Leave this blank if you are still working for this employer.Description*Position held, duties and responsibilitiesAdd a previous employer? Yes No Employment HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilitiesAdd another previous employer? Yes No Work HistoryEmployer's Name and Address* Start Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Description*Position held, duties and responsibilities Professional Qualifications Attained. Press + to add more linesInstitutionAwarding BodyDates From and To Academic Qualifications Attained. Press + to add more linesInstitutionAwarding BodyDates From and To Do you require a work permit to work in the UK?* Yes No Details of work permit requirements If offered the post, when could you start work with us?* DD slash MM slash YYYY Do you have any disabilities which may affect your employment?*Please note that this information will NOT form part of the short listing process and will not be shared with the recruiting manager at this stage. Yes No Details of disabilities Do you need reasonable adjustments to assist in your application?*Please note that this information will NOT form part of the short listing process and will not be shared with the recruiting manager at this stage. Yes No Details of reasonable adjustments Do you need reasonable adjustments to undertake the job role?*Please note that this information will NOT form part of the short listing process and will not be shared with the recruiting manager at this stage. Yes No Details of reasonable adjustments Do you require reasonable adjustments to attend interview?*Please note that this information will NOT form part of the short listing process and will not be shared with the recruiting manager at this stage. Yes No Details of reasonable adjustments Referees and pre-employment checks*We require the details of at least THREE referees, unrelated, one of whom should be your current or most recent employer. Can we contact referees prior to interview? Yes No Referee #1*PLEASE COMPLETE ALL COLUMNSNameEmailPhone No.RelationshipHow long have you known this referee?Referee #2*PLEASE COMPLETE ALL COLUMNSNameEmailPhone No.RelationshipHow long have you known this referee?Referee #3*PLEASE COMPLETE ALL COLUMNSNameEmailPhone No.RelationshipHow long have you known this referee?Safeguarding*Some appointments will be subject to a Disclosure and Barring Check as part of our child and vulnerable adults’ protection policy. Do you consent to this check being carried out? Yes No Safeguarding Contact Details Sharing Consent*All diocesan employees are required to complete two compulsory Safeguarding online training modules by the end of their probationary period. Do you consent to having your contact details shared with the Safeguarding Department in order for them to send you log in details for Safeguarding training modules? Yes No Social media checks*Social media checks will be undertaken for some roles where this is relevant to the job. Do you give consent for such checks being carried out? Yes No DECLARATION*I declare that to the best of my knowledge the information I have given is a full and true account in every respect. Confirmed CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
