PLEASE NOTE THIS PAGE ONWARDS WILL BE REMOVED FOR SHORTLISTING PURPOSES REFEREES Please give details of two referees (not related to you). If you are working, one referee must be your current or most recent employer. Referees must not be friends or family. Referee Second Referee Name Name Occupation Occupation Address Address Telephone number Telephone number Email address Email address Rehabilitation of Offenders Act, 1974 Please provide details on a separate sheet of any unspent convictions or cautions you have under the terms of the Rehabilitation of Offenders Act, 1974. Offences resulting in driving licence endorsements should be disregarded, unless holding a clean licence is a specific requirement of the job. Failure to disclose such information may result in dismissal or disciplinary action by BALTIC. This information will be treated as confidential and will not necessarily disqualify you from employment with BALTIC. Declaration In order to comply with the Asylum and Immigration Act 1996 it may be necessary to see proof of your right to work in the . If proof is required, we will request it once an offer of employment has been made and before you take up employment. However, if you require a work permit in order to work in the please indicate by ticking the box. I declare that the information contained in this Application and the Equal Opportunities Monitoring Form is correct. I understand that if I have deliberately provided false information or withheld relevant details, this could lead to disqualification from appointment or dismissal without notice. I accept that canvassing of BALTIC staff or Trustees would disqualify me from consideration, or in the event of my appointment, make me liable to dismissal without notice. I confirm that I have read the accompanying Guidance Notes, including the section regarding the Data Protection Act (1980) and consent to the processing of my data as outlined in these notes. Signature Date Recruitment Monitoring Questionnaire BALTIC is working towards achieving diversity and welcomes applications from all sections of the community. Why monitor diversity?
PLEASE NOTE THIS PAGE ONWARDS WILL BE REMOVED FOR SHORTLISTING PURPOSES REFEREES Please give details of two referees (not related to you). If you are working, one referee must be your current or most recent employer. Referees must not be friends or family. Referee Second Referee Name Name Occupation Occupation Address Address Telephone number Telephone number Email address Email address Rehabilitation of Offenders Act, 1974 Please provide details on a separate sheet of any unspent convictions or cautions you have under the terms of the Rehabilitation of Offenders Act, 1974. Offences resulting in driving licence endorsements should be disregarded, unless holding a clean licence is a specific requirement of the job. Failure to disclose such information may result in dismissal or disciplinary action by BALTIC. This information will be treated as confidential and will not necessarily disqualify you from employment with BALTIC. Declaration In order to comply with the Asylum and Immigration Act 1996 it may be necessary to see proof of your right to work in the . If proof is required, we will request it once an offer of employment has been made and before you take up employment. However, if you require a work permit in order to work in the please indicate by ticking the box. I declare that the information contained in this Application and the Equal Opportunities Monitoring Form is correct. I understand that if I have deliberately provided false information or withheld relevant details, this could lead to disqualification from appointment or dismissal without notice. I accept that canvassing of BALTIC staff or Trustees would disqualify me from consideration, or in the event of my appointment, make me liable to dismissal without notice. I confirm that I have read the accompanying Guidance Notes, including the section regarding the Data Protection Act (1980) and consent to the processing of my data as outlined in these notes. Signature Date Recruitment Monitoring Questionnaire BALTIC is working towards achieving diversity and welcomes applications from all sections of the community. Why monitor diversity?
Recruitment_Pack__FLproducer.docx