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All information given in this form is private and confidential.

Personal Details

Please ensure you bring appropriate documentation (e.g. passport, identification card or birth certificate) to the interview to support this statement if you are asked to attend. This is a non-discriminatory requirement to ensure that, if you are successful in your application to Brooke House College, you have the right to work in the UK. 

Education and Qualifications

Employment History

Please note that a full employment history is required and that any previous employers may be contacted before any offer of employment is made.

Other Information

Max file size: 10 MB


Posts involving working with students under the age of 18 are exempt from provisions of the Rehabilitation of Offenders Act 1974. You are, therefore, required to declare whether or not you have any convictions, criminal charges, summonses, or cautions pending against you, whether or not your conviction is spent. Successful applications for work with children and vulnerable adults will also be subject to a Disclosure and Barring (DBS) Enhanced Disclosure check.

Failure to declare a conviction may disqualify you from an appointment, or rest in the termination of your contract if the discrepancy comes to light. 


Please provide the names and addresses of two referees who are prepared to provide a reference. One of these should be your present or latest employer. Any offer of employment will be subject to the receipt of references considered suitable and appropriate by Brooke House College in addition to the DBS Enhanced Disclosure check, detailed on the previous page.


I certify that the information given above is, to the best of my knowledge and belief, correct. I understand that relevant certificates and other supporting documentation will be required in support of my application. I agree that consent is given to deal with the personal information in accordance with my application, to comply with GDPR and college Policy.

Please provide an email address where we can send a link to your current form.

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