Position applied for:* Location:* Where did you see the post advertised?* Personal DetailsName* First Last Address:* Street Address Address Line 2 City County Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact Telephone Number/s:*Email Address: Employment HistoryPresent or Most Recent Post: Employer: Date Started: Day Month Year Date Ended: Day Month Year Salary and Benefits: Job Title and Main Responsibilities:Previous Posts (please start with the most recent):Please click the + sign to add further employment Dates (from-to):Employer:Job Title and Main Responsibilities: Qualifications, Professional Body Memberships and Development ActivitiesPlease provide details of nationally recognised vocational and academic qualifications you have gained. including dates, subjects, awarding body and level or achievement. The Charity may verify the qualifications of the successful candidate.Please provide details of memberships to any professional body.Please provide details of relevant professional development activities.Please demonstrate how you meet the requirements of the post (maximum 750 words). You can use experience and knowledge from volunteering and any other activities you consider relevant to this position. Please give specific examples of your achievements.*Other Details:What is the notice period required in your current post? Are you a British subject or a national of any EU country?* Yes No If no, do you have the right to work in the UK and a current work permit?* Please state the expiry date of your right to work in the UK and/ or your work permit* The Fire Fighters Charity meets the requirements in respect of exempted questions under the Rehabilitation of Offenders Act 1974, and as listed in the Police Act 1997 (Criminal Records) Regulations 2002. To be eligible to request a check of the children’s or adults barred lists, the position must be eligible for an enhanced level DBS check as above and be specifically listed in the Police Act 1997 (Criminal Records) Regulations as able to check the barred list(s). The post you are applying for is subject to an Enhanced Disclosure and Barring Services (DBS) with barred list(s) check. ReferencesPlease provide details of a minimum of 2 referees covering at least a 3 year employment and/or education period. Referees must be your line manager / tutor or someone in a position of responsibility who has the authority to provide the reference on behalf of the organisation. Please note references from friends or relatives will not be accepted. Referees:*Please click the + to add further refereesName:Job Title:Address:Telephone number:Dates to and from known: Data Protection Act 2018The Fire Fighters Charity processes personal data in accordance with its Data Protection Policy. For full details of how the Charity processes your data, please see our Privacy PolicyDeclarationBy submitting this form, I hereby declare that the information I have supplied is, to the best of my knowledge, complete and correct. I understand that giving false information or omitting to give information could disqualify my application and if I am appointed could lead to my dismissal.Name* First Last Date:* Day Month Year NameThis field is for validation purposes and should be left unchanged.