Lavender Menace
Queer Books Archive

CONFIDENTIAL
APPLICATION FORM

Post: Community Project Coordinator

Closing date for application: 3 April 2023

Please complete this form as clearly as possible and return it to the email or postal address shown below. 
Do not attach CVs or other papers – please use this form only.  
	
1.  PERSONAL INFORMATION	
First Name(s) (Initials only):   

                                           	Last Name:

	Pronouns:

Home address:

Home/Mobile Telephone No:  
Work Telephone No:  
May we telephone you at work?  Yes / No
Email Address:  
	
2.  QUALIFICATION AND TRAINING	

Note: Please list below all the qualifications you have or training courses you have attended, which are relevant to this post.  Please give dates and grades and state whether the course was full or part time.  Please do not record names of any schools, colleges or universities attended.
Please insert extra rows as needed.

	

3.  WORK EXPERIENCE	

Note:  Please give details of all posts you have held, starting with your current or most recent post.
Please insert extra rows as needed.
	
From
(month & year)	To
(month & year)	Employer's Name, Address 	Job Title and Description of Duties. 
Please Indicate Reason(s) for Leaving	Final Salary 	

					

4.  BACKGROUND & SUITABILITY	

Please tell us why you think your background, experience, skills or qualities makes you a good candidate for this post. Please refer to the Person Specification in the Role Profile when completing this section.
Please ensure this section does not exceed 1 ½ pages (font size 11). 

	

5.  REFERENCES	

Please give the names and addresses of two people whom we may contact for a confidential assessment of your suitability for this job post interview. One of these should be your most recent or current employer.
	
Referee 1
Name:  
Address: 

Tel No:
Email Address:
Relationship (e.g. former employer):
	Referee 2
Name:
Address: 

Tel No:
Email Address:
Relationship (e.g. former employer):
	
6.  SOURCE	7.  IF APPOINTED	

Where did you find out about this vacancy?
	
When could you take up duties?	

8.  DISCLOSURE AND CONVICTION	

Note: Please provide information of previous convictions. Having a previous conviction does not automatically bar you from working with the LMQBA but it will help us, in discussion with you, decide if the post you have applied for is suitable. (Under the terms of the Rehabilitation of Offenders Act 1974 you are entitled to withhold information about any convictions against you which are now '‘spent'’. )
A full PVG will be required for the role, as it involve working with vulnerable adults.

	
9. ELIGIBILITY TO WORK IN THE UK	
Note:  If you do not hold a British passport, we will need to see documentation that confirms your right to work in the UK. 	
Do you hold a UK passport?	If No, can you prove you are eligible to work in the UK (please specify)?	
Yes / No

	

10.  DECLARATION	

I confirm that the information I have given on this form is correct and complete and that misleading statements may be sufficient grounds for cancelling any agreements made. I consent to the information given being retained by the LMQBA in line with our data protection policy. (If your application is successful, we will keep your personal data for up to 6 years after employment; if your application is unsuccessful, we will destroy your data after six months.)

SIGNED:  
	
DATE:  	

Please return your completed form to:	

Email:  themenaces@lavendermenace.org.uk or

Post: Lavender Menace Queer Books Archive
St Margaret’s House (Edinburgh Palette) Room G25c
151 London Road
Edinburgh EH7 6AE