Job Application Form

Amicus Trust Job Application Form

Private and Confidential

Amicus Trust is an equal opportunities employer. It aims to meet both its statutory duties in relation to equal opportunities and to follow accepted good practice in this area. Amicus Trust’s policy is that no applicant or employee should receive less favourable treatment than another on grounds of sex, marital status, race, colour, nationality, ethnic origin, religious or political beliefs, age, class, sexual orientation, responsibilities for dependants, disability or unrelated criminal convictions.

Amicus Trust has been awarded the Disability Symbol by Jobcentre Plus. This means that Amicus Trust follows a set of commitments to ensure we are positive about disabled people.

In order to ensure that we are meeting our aims, and to be able to produce supporting evidence if required, we routinely collect information on ethnicity/race, gender, disability, age and sexual orientation from all existing and potential employees for monitoring purposes only. This information is held by the Human Resources department only and forms no part of any selection process, either in your initial appointment to your post at Amicus Trust or at any time in the future.

We would be grateful therefore if you would select the categories most appropriate to yourself from the questions below and return this form, in confidence, together with your application form.
Data Protection Information

Amicus Trust (a registered charity (268639) and a company limited by guarantee (1182060)) processes your information in order to enter into a contract with you for employment. We also collect equal opportunities data, such as information about health (including disabilities), ethnic background and sexual orientation for our substantial public interest to ensure equality of opportunity or treatment. We are also are required to obtain information about your unspent criminal convictions in order to meet our obligations under social protection law.
If you are unsuccessful in your application all identifiable candidate data will be anonymised or deleted.

Your personal details held by Amicus Trust will be processed in a manner that ensures appropriate security of the personal data, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures

For information about your rights, including raising a complaint, please see -

For complaints, to exercise a right or other queries, please contact 01234 358478

By submitting this form you are agreeing to the above use for your application. For full details of our privacy policy please see

This information is needed so all applicants who have a disability that meet the minimum criteria for this position will be offered an interview.

Confidential: Amicus Trust

For Office Use:
Equal Opportunity Number:

PERSONAL DETAILS: We ask for personal details in the first section. This is removed before the interview panel decide which candidates will be offered an interview. Therefore, please take care not to have your name anywhere after this section.

Confidentail: Amicus Trust

Office use only:
Equal Opportunity Number:

Present / Most Recent employment:
Other previous employment
Please provide the following for all previous employers:
Confidential: Amicus Trust

Office use only:
Equal Opportunity Number:

Confidential: Amicus Trust

Office use only
Equal Opportunities Number:


Please give details of your present or most recent employer and one responsible person to whom you are well known but to whom you are not related, and to whom we may write for a reference concerning your suitability for this post.

By providing these details you agree to us contacting these individuals following an interview.

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 all those who need to see it. It will also form the basis of the confidential personnel record of the successful candidate. In the case of unsuccessful candidates, this application form will be destroyed after twelve months.

I declare that to the best of my knowledge the information I have given in this application form is true. I acknowledge that if it is found that I have knowingly provided false information, this will lead to the withdrawal of a job offer or termination of my employment.

Disclosure of Criminal Convictions

Disclosure of Criminal Convictions

The nature of Amicus Trust’s business involves working with vulnerable people. Therefore, ALL ’spent’ and ’unspent’ convictions must be declared.

Any information given above convictions will be completely confidential and will be considered only in relation to the job for which you are applying. The number of people rejected for employment who disclose a convictions is very small. It is very serious if you wilfully conceal convictions.