APPLICATION FORM

Please type or complete this form in black ink. The text boxes can be expanded if required. The form should contain all information relevant to your application. It can be accompanied by a current curriculum vitae (no more than 3 pages) if you wish but all questions on the form should be answered directly.

Application for the appointment as a: DATA ANALYST

PERSONAL (The storage of personal information is covered by a strict RCU Data Protection Policy)

EDUCATION AND MAJOR TRAINING COURSES (Please list all relevant education experience and detail the qualifications obtained.)

Date started

Date ended

FT/PT Place of study/training Qualification & grade/level obtained

Surname: Forename (s):

Address:

Postcode:

Contacts details:Tel (day):

Mobile:

Tel (eve): Mobile

Email:

APPLICATION FORM

CURRENT OR MOST RECENT EMPLOYMENT Confirmation of these details will be required from your current employer prior to any formal job offer being made (see section on references).

Please address all the stated aspectsName of employer/organisation

Date started

Job title, current basic salary and main responsibilities/specialisms

Reason for seeking new post

PREVIOUS EMPLOYMENT

PREVIOUS EMPLOYMENTList all positions in reverse chronological order (starting with your most recent past position). Please account for any gaps in your employment history.

Name of employer/organisation

Dates from/to

Job title and main responsibilities/specialisms

Reason for leaving

Health RecordIf you have been off sick for more than three successive days in the past two years, please give details

APPLICATION FORM

FURTHER INFORMATION IN SUPPORT OF YOUR APPLICATIONPlease use this space to expand on your experience or achievements in support of this application making direct reference to the job description. Please be concise and quote specific evidence. Do not use continuation sheets.

APPLICATION FORM

REFEREES WHO CAN COMMENT ON YOUR POTENTIAL PERFORMANCE (One should be your present or most recent educational establishment or employer. References will not be taken up prior to appointment.

Name: Address:

Tel: Occupation: Capacity in which they know you:

Name: Address:

Tel: Occupation: Capacity in which they know you:

Do you have any criminal convictions? YES / NOIf yes, enclose details on a separate sheet. Each applicant will be considered on an individual basis. Failure to provide information on a current conviction could lead to the withdrawal of any subsequent offer of employment.

Certain convictions may be regarded as spent under the above act and you may be entitled to answer NO. If you are uncertain on what answer to give, please take appropriate advice.

I declare that the information contained on this form is accurate and complete and understand that any false information could lead to the withdrawal of any subsequent job offer.

Signed: Date:

To be returned by post to Louise Breckell, RCU Ltd, 3 Tustin Court, Port Way, Ashton on Ribble, PRESTON, Lancashire, PR2 2YQ or by email to lbreckell@rcu.co.uk