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Application Form

General guidance notes:

Please read these carefully. We will decide whether or not to interview you solely by the information you give in this application form.

Personal Details

Please answer all questions. Telephone numbers are important as we may need to contact you.


Have you received a Covid-19 vaccine?

Hours of Work


We require a minimum of 2 references covering your last 2 years of employment before any offer of employment can be confirmed. If you have been in your current / most recent employment for more than 2 years, you must supply a reference from your next most recent employer. If you have worked for several employers during the last 2 years you must supply reference details for all these employers. We do not accept references from friends or relatives. If you are unable to provide the required employer references please supply contact details for a suitable person to give a character reference in the boxes below. 

Full Employment History – IMPORTANT INFORMATION

Should a job offer be made to you we will require your full employment history including any gaps in employment e.g. career break, travelling, family commitments etc.  You will need to List All the employers you have worked for in date order starting with the most recent and dating back to your first job after your education.

Employment History form can be found in the Induction Booklet which will be handed to you when you come in to complete a DBS search.

Interview Adjustments

Please provide brief details of any adjustments you may require to be made to the interview/selection process. Any information provided will be treated in the strictest confidence and will only be used where necessary to facilitate the interview/selection process.

Disciplinary Action


Under the requirements of the Immigration, Asylum and Nationality Act 2006 we need to ensure that you are eligible to work in the UK before we can employ you. If you are unclear need about the questions below please contact us for help. Proof of eligibility to work will be required at interview. Please note that Purley Park Trust does not support sponsorship of our employees.

If you have a right to work which expires and fail to provide a new document proving your right to work in the UK your employment will not be continued. By submitting the application form you give permission for us to contact the United Kingdom Border Agency to verify your immigration status and eligibility to work in the United Kingdom.

Rehabilitation of Offenders Act 1974

If this part of the form is not applicable to you, please select NO or write N/A.
Please do not leave this section blank.

The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020) provides that when applying for certain jobs and activities, certain convictions and cautions are considered ‘protected’. This means that they do not need to be disclosed to employers, and if they are disclosed, employers cannot take them into account.
Guidance about whether a conviction or caution should be disclosed can be found on the Ministry of Justice website.

You are advised that you are not entitled to withhold information about convictions which are regarded as ‘spent’ under the Rehabilitation of Offenders Act 1974. This is because the nature of the work involved in this appointment renders the post exempt from section 4(2) of the Act by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975 (as amended). Information that you give will be strictly confidential and will be considered only in relation to this or similar exempted positions in the organisation.

Do you have any convictions or cautions (excluding youth cautions, reprimands or warnings) that are not ‘protected’ as defined by the Ministry of Justice? Guidance can be found at:

NB: We are required by law to obtain a Disclosure from the Disclosure and Barring Service for all employees working with vulnerable people ‘in regulated activity’.  You will be required to complete a disclosure application form and provide us access to the completed disclosure certificate once completed prior to joining the organisation.


In accordance with the General Data Protection Act 2018, I consent to, and in particular the processing of any ‘sensitive data’ (as defined in the general data Protection Regulations 2018) including information relating to my racial or ethnic origin or religious or similar beliefs in order to monitor compliance with the equal opportunities legislation and information relating any criminal proceedings in which I have, or I am alleged to have been involved, being processed by Purley Park Trust Ltd for legal, personnel, administrative and management purposes in connection with the recruitment for this or any other post.

I declare that the information provided in this application is correct to the best of my knowledge and, if I am appointed, will form part of my contract of employment. Any false information may be sufficient cause for rejection of the application, withdrawal of an offer of employment, or if employed, dismissal.

For data protection reasons we will only retain your personal data for a maximum of 3 months (in paper or electronically) from the date of submission then your data will be destroyed.  If we have any vacancies which we think you might be interested in we will contact you during this period.  After 3 months you will need to complete a new application form.
If you wish to see a full copy of our Job Application Privacy Notice please contact our HR Department.