Job Vacancy Applying Form – Shan-e-Islam

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Job Vacancy Applying Form

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Personal Information - Step 1 of 11

SECTION 1a - Personal Information

Position Applied for *

Title *

(Mr, Miss, Mrs etc.)

Full Name *

First

Middle

Last

Upload a Photo of Yourself *

Where possible, provide a photo of yourself against a plain white background.

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Home Telephone

Mobile Number *

Email *

Email

Confirm Email

Nationality *

Date of Birth *

Place of Birth *

Country of Birth *

Have you lived at any other address in the last 5 years? *

Yes
No

Address 1

Address Line 1

City

State / Province / Region

Postal Code

Country

Add another?

Yes
No

Address 2

Address Line 1

City

State / Province / Region

Postal Code

Country

Add another?

Yes
No

Address 3

Address Line 1

City

State / Province / Region

Postal Code

Country

Add another?

Yes
No

Address 4

Address Line 1

City

State / Province / Region

Postal Code

Country

National Insurance Number *

Are you eligible to work in the UK? *

Yes
No

Do you hold a full UK driving licence? *

Yes
No

Do you have any points or convictions etc? *

Yes
No

Please provide details *

SECTION 1b - Emergency Contact

Name *

First

Middle

Last

Relationship to Applicant *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Home Telephone

Mobile Number *

Email *

Email

Confirm Email

SECTION 1c - Next of Kin

Name *

First

Middle

Last

Relationship to Applicant *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Home Telephone

Mobile Number *

Email *

SECTION 2 - Health

Have you been absent from work in the past 2 years? *

Yes
No

State total number of days *

Number of occasions *

Are there any Medical Conditions we should be aware of? *

Yes
No

Please specify conditions *

Are you registered disabled? *

Yes
No

Provide your disability number and details *

SECTION 3 - Qualification / Achievements

Qualification 1

Please start with the latest Qualifications / Achievements

Date from *

Date to *

Name of Institution *

Examinations taken and Qualifications Gained (Specify Grades) *

Add another?

Yes
No

Qualification 2

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

Add another?

Yes
No

Qualification 3

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

Add another?

Yes
No

Qualification 4

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

Add another?

Yes
No

Qualification 5

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

Add another?

Yes
No

Qualification 6

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

Add another?

Yes
No

Qualification 7

Date from

Date to

Name of Institution

Examinations taken and Qualifications Gained (Specify Grades)

SECTION 4 - Relevant Experience / Employment

Name and address of Institution/ Employer *

Date from *

Date to *

Job Title *

Salary *

Reason for Leaving *

Add another?

Yes
No

Previous Employer 2

Name and address of Institution/ Employer

Date from

Date to

Job Title

Salary

Reason for Leaving

Add another?

Yes
No

Previous Employer 3

Name and address of Institution/ Employer

Date from

Date to

Job Title

Salary

Reason for Leaving

SECTION 5 - Personal Profile

Use this section to add any further information which directly relates to your suitability for this position *

SECTION 6 - Why do you want to work for JAMIA SHAN-E-ISLAM?

Why do you want to work for JAMIA SHAN-E-ISLAM? *

SECTION 7 -References

Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your referees are. (NB. References will only be taken if you commence employment with us)

Referee 1

Name *

First

Last

Work Relationship *

Organisation *

Date Employed From *

Date Employed to *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Work Telephone *

Email *

Email

Confirm Email

Referee 2

Name *

First

Last

Work Relationship *

Organisation *

Date Employed From *

Date Employed to *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Work Telephone *

Email *

Email

Confirm Email

Bank Account Details

Name of Bank / Building Society *

Account Payee Name *

Bank Sorting Code *

Example: 20-50-40

Account Number *

8 digits

Roll Number (if applicable)

Usually for Building Society Accounts

SECTION 8 - Declaration

I confirm that the information provided in this application and within my Curriculum Vitae is both truthful and accurate. I have omitted no facts that could aﬀect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file. *

Please tick if you agree with the above statement,

It is a condition of your employment that you have a satisfactory enhanced Disclosure and Barring Certificate. If such a certificate is not supplied, or if when it is received, it is not deemed suitable to us, your employment will be terminated. During your employment with us you will be asked to submit to further checks and if any such check contains information which we feel is not acceptable, your employment with us may be terminated. Jamia Shan-e-Islam undertakes that it will treat any personal information that you provide to us, or that we obtain from you, in accordance with the requirements of the Data Protection Act 1998. After initial assessment, Jamia Shan-e-Islam may keep your details on le pending suitable opportunities that may arise in the future. *

Please tick if you agree with the above statement,

Name *

First

Last

Date *

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