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PERSONAL DETAILS
(PRIVATE AND CONFIDENTIAL)
Job title:

Closing date:

Where did you hear about this vacancy?

Personal Details This information is detached prior to your application being considered
Title

First name(s)

Address

Surname

Preferred Name

Email address

Preferred method of
contact:

Telephone
Mobile

Postcode
Date of birth

E-mail
Phone
Post

Gender

National Insurance number

Do you have the legal right to work in the UK? Yes

No

If Yes and there are conditions attached, e.g. start and finish dates, please specify:
If No what type of work permit do you require?

References Please provide an email address as first point of contact for referees
Name

Position/occupation

Address

Email
Relationship
Length of time you have known this person

Postcode
May we contact this person prior to interview? Yes

No

Name

Position/occupation

Address

Email
Relationship
Length of time you have known this person

Postcode
May we contact this person prior to interview? Yes

No

Name

Position/occupation

Address

Email
Relationship
Length of time you have known this person

Postcode
May we contact this person prior to interview? Yes

No

Disability
Do you consider yourself to have a disability? Yes

No

If Yes please state the nature of the disability. Would you need any adjustments to be made to
allow you to successfully perform this role?
Do you need any special assistance in attending interview? If so, please give details:
The Disability Discrimination Act 1995 defines a disability as a physical or mental impairment which
has a substantial and long term adverse effect on your ability to carry out normal day to day activities.

Have you ever been convicted of a criminal offence? Yes

(Declaration subject to the Rehabilitation of Offenders Act 1974, enclosed)

Ethnicity Which is your ethnic group?

No

White
White British
White Irish
Gypsy or Irish
Traveller
Any other White
background

Asian or Asian British

Indian
Pakistani
Bangladeshi
Any other Asian
background

Mixed
Mixed White &
Black Carribbean
Mixed White &
Black African
Mixed White &
Asian
Any other Mixed
background

Black or Black British

Black or Black
British African
Black or Black
British Caribbean
Any other Black
background

Chinese or other
ethnic group
Chinese
Any other ethnic
group
Please specify

Sexual Orientation
Heterosexual

Homosexual

Bisexual

Other

Prefer not to say

Religion
Christian

Buddhist

Hindu

Jewish

Muslim

Sikh

No religion

Other

Medical Information Please comment on your current health status if you feel this would be
helpful:
In accordance with the Data Protection Act 1998, the information provided on this form will be
used in the recruitment and selection process and may be disclosed to those who need to see it.
It will also form the basis of the confidential HR record of the candidate. In the case of

unsuccessful candidates, the Personal Details and Application Form will be destroyed after 6
months.
I hereby declare that to the best of my knowledge, all the information given by me is correct and
that I possess all the qualifications I have listed on this form. I agree that the Theatre Royal
Plymouth Ltd ha the right to validate any of the information provided.
I understand that any false statements could results in my dismissal, if appointed.
Signed:

Date

APPLICATION FORM
Please refer to our guidance notes before completing in blue or black ink

Employment History
Please provide information on your most relevant employment, starting with the most recent
Employer

Job title

Start
date

End
date

Reason for leaving

Please give details of your two most recent or relevant positions

Employer

Dates employed

Job title

Notice period

Summary of duties

Reason for leaving

Rate of
pay

Employer

Dates employed

Job title

Notice period

Summary of duties

Reason for leaving

Educational, technical and professional qualifications

Academic/personal qualifications attained or working towards - most recent
first
Place of study/professional body

Subject

Attainment level
or result

Other relevant development or training most recent first

Course name and details

Professional membership

Date

Date
gained

Memberships of professional bodies/institutes/associations or relevant organisations

Do you have any other work commitments, either paid or unpaid, which you would wish to
continue with if offered employment?
Yes

No

If Yes please provide details

Supporting Statement
Please use this space to state your reasons for applying for the post, relating your skills,
experiences and personal qualities to the job requirements.

Supporting statement continued from overleaf (if necessary)

Please return your completed application form to:

HR Department
Theatre Royal Plymouth
Royal Parade
Plymouth
PL1 2TR
or email it recruitment@theatreroyal.com.
INTERNAL USE ONLY
Short listing:

Matching abilities and skills to essential & desirable criteria

Meets

Please
tick

Comments/feedback

A=ALL
B=MOST
C=SOME
D=NONE
Invite
interview

to

No

Yes

Start date (if applicable)

Salary

Offer employment Yes

No

____________________

per annum / month / week

DBS check required? Yes

No