This form can be supplied in alternative formats if required - please contact us.

Vacancy Title: The Audience Club Project Manager

Please tell us how you heard about this vacancy:
1. Personal details
Last Name: First Name:
Address:


Postcode:
Home Telephone No. aytime !ontact No.
"#mail address:
$. Available Hours
This position re%uires a very &le'ible wor(in) pattern and the Pro*ect +ana)er will need to mana)e their own diary.
,e understand that this position will li(ely be mana)ed alon)side other commitments and only re%uest that
you indicate when other commitments mean you would not be available to wor(:
Please tick hen !ou are unavailable"
+on Tues ,eds Thurs Fri -at -un
+ornin)
A&ternoon
"venin)
.& appointed when could you start/
The interview date &or the position is 0ctober 11
th
$213. !an you attend an interview in "'eter on this date/
1. "ducation45uali&ications
-chool4!olle)e4Hi)her "ducation
5uali&ication
ate 0btained
6ob Application Form

Trainin) and evelopment
Please use the space belo to give details of an! training or non-qualification based development hich is
relevant to the post and supports !our application.
Trainin) !ourse
!ourse etails
7includin) len)th o& course4nature o& trainin)8

3. "mployment History
Previous "mployment: Please include an! previous e#perience $paid or unpaid%& starting ith the most recent
!urrent or most recent employer
Name o& "mployer:
Position Held:
Type o& !ontract: Part#Time 4 Freelance 4 Full#Time 4 !ontract 7delete as appropriate8
ate -tarted: Leavin) ate:
9eason &or Leavin):
:rie& description o& duties:

Previous employer
Name o& "mployer:
Position Held:
Type o& !ontract: Part#Time 4 Freelance 4 Full#Time 4 !ontract 7delete as appropriate8
ate -tarted: Leavin) ate:
9eason &or leavin):
:rie& description o& duties:

Previous employer
Name o& "mployer:
Position Held:
Type o& !ontract: Part#Time 4 Freelance 4 Full#Time 4 !ontract 7delete as appropriate8
ate -tarted: Leavin) ate:
9eason &or Leavin)
:rie& description o& duties:

Previous employer
Name o& "mployer:
Position Held:
Type o& !ontract: Part#Time 4 Freelance 4 Full#Time 4 !ontract 7delete as appropriate8
ate -tarted: Leavin) ate:
9eason &or Leavin)
:rie& description o& duties:

Continue on separate sheet if necessar!
;. .n&ormation in support o& your application
,hy have you applied &or this post/
,hat e'perience do you have o& wor(in) with or supportin) people with learnin) disabilities/
,hat e'perience do you have o& the arts/
,hat speci&ic personal %ualities4stren)ths will you brin) to this post/
Please record any additional in&ormation you &eel would be use&ul in support o& your application. .t is
important that you tell us as much as possible about yoursel& in relation to the *ob description and
person speci&ication< usin) speci&ic e'amples where possible.
Continue on a separate sheet if necessar!
=. !onvictions4 is%uali&ications
To ensure the safet! of our members a '() check must be completed for all positions. A criminal record ill not
necessaril! be a bar to obtaining a position. *f a check is returned and reveals an! information& this ill be
discussed ith the applicant. The +ecruitment Team ill make a decision as to hether the offer of emplo!ment
should be ithdran.
9ehabilitation o& 0&&enders Act 1>?3 7"'ceptions87Amendment8 0rder 1>@=
,e would draw your attention to the &ollowin) statement:#
,(ecause of the nature of the ork for hich !ou are appl!ing& this post is e#empt from the provisions of
)ection -$.% of the +ehabilitation of /ffenders Act& 012-& b! virtue of the +ehabilitation of /ffenders Act 012-
$3#ceptions% /rder 0124 and the +ehabilitation of /ffenders Act 012- $3#ceptions% $Amendment% /rder 0156.
Applicants are& therefore& not entitled to ithhold information about convictions hich for other purposes are
7spent8 under the provisions of the Act9.
Please provide details below i& you have been convicted o& a criminal o&&ence or been the sub*ect o& a
conditional dischar)e or probation order. $Past criminal proceedings are not necessaril! an obstacle to
taking up a post. This occurs onl! here the offence:s is:are deemed relevant. An! details ill be discussed
ith !ou should !ou be the successful candidate based on !our supporting statement& intervie and tests%.

?. 9easonable Ad*ustments4Arran)ements &or .nterview

*f !ou need us to make an! adaptations for !our intervie to accommodate an! access requirements please tell us
hat these should be"
@. Asylum and .mmi)ration Act 1>>=
Please confirm that !ou have the right to ork in this countr! ;3) : </
'o !ou require a ork permit to ork in this countr!= ;3) : </
*f !es& please provide details
9e&erences
Please give the detail of two references one must be !our most recent emplo!er.
Are you happy &or us to contact re&erees prior to interview/ A4N
Name o& 9e&eree
and relationship
to you:

Address:

Postcode:
"mail: Tel:
Name o& 9e&eree
and relationship
to you:

Address:

Postcode:
"mail: Tel:
eclaration
-tatement to be -i)ned by the Applicant
Please complete the folloing declaration and sign it in the appropriate place belo. *f this declaration is not
completed and signed& !our application ill not be considered.
. con&irm that all the in&ormation )iven by me on this &orm is correct and accurate and . understand that
i& any o& the in&ormation . have provided is later &ound to be &alse or misleadin)< or i& . have omitted
any si)ni&icant in&ormation &rom this application &orm< any o&&er o& employment may be withdrawn
or employment terminated.
-i)ned: ate:
Please send your completed &orm electronically to
Annemarie.macdonaldBtheatrealibi.co.u(