You are on page 1of 6

The Leprosy Mission Bangladesh

Application Form
Answers requiring more space should be continued on a separate sheet.

CONFIDENTIAL
1.

POSITION APPLIED FOR


Available for employment (date)

2.

PERSONAL DETAILS
Surname:
First name(s):
Address:

3.

Email address:

Mobile No:

Telephone no:
Daytime

Evening

EDUCATION/TRAINING
Please give details of any education or training undertaken that is relevant to the
position applied for.

Course title or area of training

4.

Date

COMPUTER SKILLS
Please provide details of your word-processing, spreadsheet, database and any
other computer or IT skills you have.
Date
Course title or area of training

5.

PRESENT OR MOST RECENT OCCUPATION


Employer

Dates (from.. to..)

Job Title

Main responsibilities:
Reason for leaving:
Current salary and benefits:
6.

PREVIOUS POSITIONS - Work backwards from the most recent

Employer

Dates (from.. to..)

Job Title

Dates (from.. to..)

Job Title

Dates (from..to..)

Job Title

Main Responsibilities:

Employer

Main Responsibilities:

Employer

Main Responsibilities:

(please continue to add more boxes should you need to add more information)
7.

REFLECTION
What has most satisfied you in your career to date?

8.
3

What have you found particularly difficult?

9.

CHRISTIAN INVOLVEMENT
Name of your present church and denomination:

How long you have been in church membership?

What does your Christian Faith mean to you?

How do you maintain and strengthen your Christian Life?

What forms of Christian ministry are you involved in?

How do members of your family feel about your offer of Christian service?

10.

YOUR APPLICATION

a)

Why does this job interest you?

b)

Please describe the skills, knowledge and/or experience which you would bring to
this job?
(Please use the requirements of the person specification as a guide for answering
this question)

11.

INTERESTS/HOBBIES/VOLUNTEER EXPERIENCE
Please list any interests, hobbies and/or voluntary experience you have:

12.

HEALTH
Are you in good health?
Have you had any major health problems which could affect your work:
Yes / No (circle applicable answer)
If so, please describe:

13.

YOUR REFEREES
Please give details of 3 referees, including a recent employer and your church leader
indicating if they can be contacted should you be short-listed for the post:
Recent Employer:

Name:
Address:
Postcode:
Email Address:
Telephone:
Occupation:
My recent employer may be contacted should I be short-listed for the post: Yes / No
Church Leader:
Name:
Address:
Postcode:
Email Address:
Telephone:
Occupation:
My Church leader may be contacted should I be short-listed for the post: Yes / No
Other:
Name:
Address:
Postcode:
Email Address:
Telephone:
Occupation:
The above person may be contacted should I be short-listed for the post: Yes / No

14.

DECLARATION
The facts set out in this application form are, to my knowledge, true and complete
Signature:

Date:

You might also like