Office use only: REFERENCE NO.
JOB APPLICATION FORM
Please take care when completing the application form as the decision to shortlist for
interview will be based entirely on the information you provide. Refer to the Person
Specification and Job Description whilst completing this form.
Job applied for: Town Ranger
Please attach to this application a Risk Assessment that you have produced prior to carrying out a job task.
YOUR PERSONAL DETAILS
Title: (Mr / Mrs / Miss / Ms / Dr)
First Names:
Family Name:
Previous Family Name (if applicable):
Contact details
Current Address:
Home Telephone no:
Mobile:
E-mail:
Business number (if we can contact you at work):
Postcode:
Date / Place of Birth:
National Insurance No:
REFERENCES
Please provide the names and addresses of two referees who can comment on your suitability for this job. Please note
one must be your current or most recent employer. Do not use friends or relatives.
1. Name
2. Name
Position Position
Relationship
to applicant
Relationship
to applicant
Address:
Address:
Postcode: Postcode:
Tel no: Tel no:
E-mail: E-mail:
1
If you are shortlisted, your referees will be contacted prior to your interview. If you do not want us to contact them before
your interview, please let us know why not.
SUPPLEMENTARY INFORMATION
Under the Working Time Regulations 1998, the Council must monitor the hours worked by its
employees. Please confirm whether this will be your only employment. If not, please provide
details including days and hours worked / work pattern. (Delete as appropriate)
Yes No
CURRENT / MOST RECENT EMPLOYMENT
Name and address of current or
most recent employer:
Telephone number of your employer:
Job Title:
Date Appointed:
Notice required to leave:
Date left last job (if applicable):
Present Salary
Reason for leaving:
Outline your main tasks and responsibilities
2
Please state the reasons why you are applying for this job. This is an important part of your application
and we strongly advise you to use this opportunity to explain your suitability for the job. All information is used
to draw up a shortlist and is directly related to the fair assessment of your application. If you do not provide
sufficient evidence on these points, your application may be rejected.
In your application pack, you have been given a Job Description, Person Specification which identifies the
essential and desirable experience and knowledge required for the job. Please provide examples and evidence
of your experience and abilities which relate directly to the job being applied for.
3
EMPLOYMENT HISTORY
Other previous employment (most recent first). You may attach an additional sheet if required.
Please include if applicable periods of unemployment, voluntary work etc.
Dates - from
DD/MM/YYYY
Dates - to
DD/MM/YYYY
Name and address of
Employer
Job Title and Brief description of duties
Please continue on a separate sheet if necessary and attach to application file.
4
EDUCATIONAL and OTHER QUALIFICATIONS OBTAINED
If the job applied for requires you to hold a particular qualification, you will be asked to produce
original evidence if shortlisted for interview.
Relevant Qualifications
(e.g.GCSE, NVQ, City & Guilds,
Degree etc.)
Subject
(Qualification title)
Grade
(e.g. A, B, C, 1, 2,
3,Distinction, Pass
Office use only
Certificates
Checked
OTHER TRAINING AND DEVELOPMENT: Please list below relevant job-related training, specialist
training. (see Job Description and Person Specification)
Title and brief description of course/qualification
Date
DD/MM/YYYY
ABSENCES FROM WORK
Please give brief details of any absences from work during the last year, or state none.
5
OUTSIDE INTERESTS
Closing date for applications is 9am Monday 20
th
July 2020. Please return completed application
to: The Deputy Clerk, The Old Courthouse, Jaycroft Road, Burnham-on-Sea, Somerset, TA8 1LE or
via e-mail: info@burnham-highbridge-tc.gov.uk
Interviews will be held on Friday 24
th
July
I declare that to the best of my knowledge all the information on forms A and B, and any additional material
supplied, is correct and that it may be used for purposes registered by the Council under the General Data
Protection Regulation and Data Protection Act 2018. I understand that the withholding of relevant information
or providing any false or misleading statement could result in the application being rejected or summary
dismissal if appointed.
Yes:
If your application form is received electronically without your signature, and you are asked to attend
for interview, you will be asked to sign the form at a later date, but in the meantime, please indicate
your declaration that the information is correct by ticking the box above.
Signature: Date:
6
ADDITIONAL INFORMATION REQUIRED
Please give details of any “unspent” criminal convictions as defined in the Rehabilitation of Offenders Act 1974. A criminal
record will not necessarily be a bar to obtaining a position at the Council.
Are you related to a Councillor, or Employee, of the Burnham-on-Sea & Highbridge Town Council?
If yes, please provide their name and position:
Yes
No
Have you worked for Burnham-on-Sea & Highbridge Town Council or any other local authority via
a Temporary Employment Agency within the last six months? If so, give details:
Yes
No
Asylum and Immigration Act 1996. It is a criminal offence to employ anyone whose migration
Yes
No
status prevents them from working in the UK. The Town Council has obliga
tions under the
Asylum and Immigration Act. Please confirm below whether, if selected for appointment, you will
be able to provide a relevant document e.g. birth certificate, passport, P45 or pay slip, to meet this
obligation prior to commencing any employment offered. If No, give details
Have you received a redundancy payment or a pension from previous local authority
Yes
No
employment?
If yes, please state employer’s name and month / year the payment or pension was received:
PLEASE NOTE THE FOLLOWING:
Canvassing of Members of the council directly or indirectly for any appointment under the Council will disqualify the
candidate concerned for that appointment. A candidate who fails to disclose any relationship with a Member or employee
of the Council, or deliberately supplies information which they know to be false, will be disqualified for the appointment
and if appointed, will be liable to dismissal without notice.
In accordance with the Data Protection Act 1998 all information given on this application form will only be used to
determine an applicant’s suitability for the job and will be kept only for those purposes and equal opportunities monitoring.
Application forms for unsuccessful candidates will be retained for a period of six months before being destroyed.
Please indicate how you heard about this vacancy
Local Newspaper
Burnham-on-Sea.com
Word and mouth
Town Council website
If you have a disability, are there any arrangements we can make for you if you are called for an interview? (e.g. ground
floor venue, hearing loop, etc.)
Do you hold a current full driving licence? Yes / No
7
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome