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NEWBURYbuilding society

Job Application Form

Please complete all sections in BLOCK CAPITALS Fields marked with an asterisk * are required.

Position:

Position applied for*

Location / Branch*

Surname*

Forename(s)*

Preferred Forename(s)*

Email*

Date of Birth*

Personal details

Address*

*

*

Postcode*

Home telephone*

Work telephone*

Previous Address(es) in the last 3 years

Address

Postcode

From

To

Address

Postcode

From

To

Previous name(s)

Previous name(s)

Date name(s) changed

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Employability

Do you need a work permit for employment in the UK?

Yes No

National Insurance Number

Have you been convicted of a criminal offence, which is not a spent conviction under the Rehabilitation of Offenders Act?

Yes No

If “Yes” give details

Do you have a full valid driving licence?

Yes No

Please give details of any points/penalties

Are any of your friends/family employed at Newbury Building Society?

Tick for Yes

If “Yes”, in what capacity?

Data Protection Act

Under the Data Protection Act 1998, the general information you supply about yourself in this form is known as your personal data and information about any criminal convictions, ethnic origin and health is called ‘sensitive personal data’.

The society will process (i.e. record and use) your personal and sensitive personal data for its internal records and to assist in the selection for employment process. It may also need to disclose your data, including sensitive personal data, to the following organisations:

• Present and previous employers and persons nominated as personal referees so that references may be obtained

• Credit Reference Agencies so that your credit worthiness may be checked. These agencies may retain a record of our searches which will beavailable to other organisations that grant credit

• The Financial Conduct Authority or Prudential Regulation Authority for regulatory purposes

• Criminal Record Bureau if you are appointed so that any previous convictions may be checked

• The Society’s medical advisers in order to check any special arrangements that might be necessary to accommodate a medical condition

• Any other third parties to (a) meet compliance obligations (b) administer Society payroll and benefits.

This form will be destroyed after three months if you are not short-listed for an interview, and after six months if you are interviewed and not appointed. Before the Society can process your personal and sensitive data it needs your explicit consent to do so.

Name of business

Address

Postcode

Type of business

Job title

Present employment

Brief description of your job (key tasks)

Employment from

Employment to

Notice period

Present salary

Reason for wanting to leave

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Name of business

Address

Postcode

Type of business

Job title

Present employment

Brief description of your job (key tasks)

Employment from

Employment to

Reason for leaving

These details must cover your full career. Please complete in FULL, starting with the most recent and working back.

Should your application be successful we will contact your current or most recent employer(s) to obtain references to cover the last five years. Continue on a separate sheet if necessary.

Name of business

Address

Postcode

Type of business

Job title

Brief description of your job (key tasks)

Employment from

Employment to

Reason for leaving

Business name Dates employed Start/End Reason for leaving

Please provide an explanation for any period you were not working within the past 10 years

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Education/Training/Personal development

GCSE/O’Level subject Dates passed Grade

Subject Dates passed Grade

Other qualifications including A’Level, GNVQ, degree and professional

PC Skills: experience of (please tick box)

Word Excel Powerpoint Outlook Internet/Email

Other packages (please specify) Details of professional courses and work-based training

Contact name

Company name

Address

Postcode

Telephone

Email

Relationship/Status

References

Please give details of two professional people who we may contact for employment references. One must be your current or most recent employer, or college if you have no previous work experience. References are required to cover the last five years. Continue on a separate sheet if necessary. We only take up references if you are offered employment.

Contact name

Company name

Address

Postcode

Telephone

Email

Relationship/Status

Please tick box if we may contact these referees BEFORE you accept an offer of employment

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Additional Information

Working as part of a team, communicating effectively, meeting customer expectations and attention to detail are important aspects of the role you have applied for. Please use the space below to describe your suitability for the role and how you feel you meet these criteria, providing examples, where possible, from any aspect of your life.

Declaration

Please read carefully. If you do not understand the declaration or you feel unable to give your consent, please contact our Human Resources department for further information.

If you have ever worked within a regulated environment as an authorised Financial Adviser in the past ten years please tick here

and state the name of company(ies)

i. I declare that I am not currently or have ever been subject to disciplinary action during any period of employment.

ii. I declare that if I have worked as an authorised Introducer, I have not been disciplined, suspended or dismissed in connection withregulated activities.

iii. I declare that I have not been convicted by a court (civil or military) for offences (other than a motoring offence unless resulting indisqualification from driving) which are not spent under the Rehabilitation of Offenders Act 1974 or have been subject to penalties fortax evasion. For information on what constitutes a spent conviction visit www.justice.gov.uk

iv. I declare that I have not been a defendant in any civil proceedings, or a party to any arbitration, in relation to investment business or otherfinancial business, or the subject of any criminal proceedings.

v. I declare that I have never: had any judgement debt entered against me; made any compromise or arrangement with one or more of mycreditors; ceased trading in circumstances in which one or more of my creditors did not receive full payment; had a petition for bankruptcypresented against me; been declared bankrupt; had my estate sequestered or am currently aware of any pending proceedings for any ofthe above.

vi. I declare that I have never been refused or had revoked or withdrawn, any authorisation to carry out insurance, investment orbanking business.

vii. I declare that I have not resigned or been dismissed from any previous employment for any reason connected with any actual or allegedbreach of the rules of any regulatory body (e.g. Financial Conduct Authority) or a conviction for any offence involving fraud,dishonesty or violence.

viii. I declare that the answers given on this Application (and elsewhere in support of it) are true and complete to the best of my knowledge andbelief. I understand that providing misleading or false information will disqualify me from appointment or if appointed may result inmy dismissal.

ix. I agree to personal vetting searches being made.

x. I agree to the CRB (Criminal Records Bureau) check being made where it is deemed appropriate.

Please tick this box if you disagree with any of the statements made above.

If you disagree, please state details:

I confirm that I have read and understood the above information regarding personal data and sensitive personal data. I agree and consent to you processing my personal data. *

To complete your application, please email the completed form to jobs@newbury.co.uk