Application Form
Lichfield Diocesan Board of Finance
Please complete this application form electronically and return by email to HR@lichfield.anglican.org as a MS Word Document

PERSONAL INFORMATION

Post applied for:	
		
Where did you see this post advertised:	

Surname:	
	
First names in full (block capitals):	
	
Preferred name:	
	
Address:	
	
Telephone No. (that we may use to contact you):	
	
Email:		
	
Are you eligible to freely live and work in the UK without restriction?	Yes ☐    No ☐
	
Where did you see this role advertised?

EDUCATION & TRAINING
Please list education, training, relevant professional qualifications and membership of professional organisations Please give grades and dates.

EMPLOYMENT HISTORY
Starting with your current/most recent appointment, please list your current and previous employment, the box will extend as you complete it. If the role you are applying for requires a DBS check, you must also account for any gaps since leaving school. Those who are CofE Ministers should state the parish/chaplaincy which they were licensed to.

Name and address of employer	Start and leave date	Post held and brief description of responsibilities	Reason for leaving	

INFORMATION IN SUPPORT OF YOUR APPLICATION 
Please give examples of how you meet the criteria set out the role description and person specification and explain what attracts you to this role, and this will be used in shortlisting of applications.  Examples can be taken from work, volunteering, community, extra-curricular activities etc. If this post has an occupational requirement (OR), please state how you meet this. You can expand this box to give as much information as possible.

	

REFEREES

Yes/No	
Are you ordained in the Anglican Communion or have you been admitted to the office of Licensed Lay Worker / Reader? 

It is our policy that any employees who have been ordained in the Anglican Communion or have been admitted to the office of Licensed Lay Worker / Reader are of such good standing to hold the Bishop’s Licence and/or Permission to Officiate. For these people, an Episcopal Reference will be sought in addition to the referees provided below.

1. Current/most recent employer/academic (please indicate)
Name:		
Job title/organisation:		
Phone:		
Email:		
Address:		

May we contact this person now?	Yes ☐    No ☐	
2. Previous employer/another manager/academic (please indicate)
Name:		
Job title/organisation:		
Phone:		
Email:		
Address:		

May we contact this person now?	Yes ☐    No ☐	

What is the period of notice you required in your current role?

CONFIDENTIAL 
You have been asked to submit this document as a MS Word document so that this section can be removed before it is sent to the shortlisting panel. It will only be seen by the HR Team.

Proscribed organisations
Those employed by the diocese, as well as clergy, ordinands and lay ministers, as representatives of the Church may not be a member of or promote or solicit support for a party or organisation whose constitution, policy objectives or public statements are declared in writing by the House of Bishops to be incompatible with the Church of England's commitment to promoting racial equality. This explicitly includes the BNP. 
Yes ☐    No ☐	
Please confirm that you are able to comply with this:	

Disclosure of conviction(s) 
Applications from ex-offenders are welcomed and will be considered on their merit. Convictions that are irrelevant to this job will not be taken into account. You are required to disclose any convictions, which are not ‘spent’ by virtue of the Rehabilitation of Offenders Act 1974. For legal and accounting professions as well as those working in Regulated Activity – generally those requiring an Enhanced DBS check, you are required to disclose all convictions, including those that are ‘spent’ by virtue of the Rehabilitation of Offenders Act 1974.

Have you been convicted of a criminal offence that is not spent, or in the case of a role which is eligible for a DBS, any criminal offence? If yes, please give details of date(s), offence(s) and sentence(s) passed.

Please outline any reasonable adjustments you may need if invited to attend an interview. 

DECLARATION

To the best of my knowledge and belief, the information supplied by me in each section of this form is correct. If it is later discovered that information contained herein was incorrect, misleading or not fully disclosed, we reserve the right to terminate your employment or any offer of employment.

Signed (type name):		Date: