Skillshare International | Application Form:

Please complete this form and send it to the address below:

Leicester Office
126 New Walk, Leicester LE1 7JA, UK

Or as an email attachment to:

recruitment@skillshare.org

With all multiple choice questions please delete as applicable.
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1.            About You:
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1.1 Post applied for:                  
				
1.2 Have you read/received 
     a job description?		Yes/No

1.3 For what length of time
     would you be able to 	
     work as a development 
     worker/health trainer?	6 - 12 Mnths /  12 - 18 Mnths / 18 -24 Mnths
        
1.4 Salutation:			Mr / Mrs / Miss / Ms / Dr

1.5 Full Name:			
				
1.6 Email Address:

1.7 Postal Address:
      Country:
      Postal Code:

      Tel Home:
      Tel Work:

1.8 Date of Birth:

1.9 Status:			Single /Engaged /Married /Cohabiting /Divorced /Separated/Widowed
      Since:

1.10 Citizenship:

1.11 N.I. Number (if applicable):

1.12 Do you hold a current
       driving Licence:		Yes/No
       Country of issue:

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 2.           Couples:
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Please note that if you are both applying to go overseas as development 
workers/health trainers it may not be easy to place you both in the same area. 
Please complete an application form each. 
Flights and medical cover may be provided for partners who are not 
development workers/health trainers. We shall try to indicate in the job 
descriptions whether or not accommodation is suitable for accompanied 
development workers/health trainers. 

2.1 Is your partner applying to become a development worker?                  	Yes/No

2.2 If so, what is their name?

2.3 If not, do you intend to live together overseas during your placement?		Yes/No

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3.            Children:
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In certain circumstances Skillshare International is able to recruit people with children. 
In which case, Skillshare International will provide flights and medical cover. 
We shall try to indicate the possibility of this on the job descriptions. 
You should think carefully about taking your children with you. 
living conditions and the education system will be very different. 

3.1 Do you have dependent children?	Yes/No

3.2 If yes what are their ages?

3.3 Will any of them accompany you?	Yes/No

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4.            Finance:
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Please think carefully about the financial implications of working as a development 
worker/health trainer. You will be paid a monthly allowance. 
The monthly allowance is enough for a reasonable standard of living, 
but not enough to provide for savings et cetera. 

4.1 Do you have any financial
     commitments, eg life insurance
     mortgage, maintenance et cetera?		Yes/No

4.2 How much are you committed
     to paying each month on average? 		£

4.3 How will you meet these commitments?
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 5.            Availability:
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5.1 Please tell us on which dates you are not available for interview?

5.2 When will you be able to take up the position?

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 6.           Your Work: 
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Please give brief details of your work experience starting with your most recent job. 
Please list your duties and responsibilities in each job, especially where you have
trained and supervised others. Please do not use abbreviations.

A. Work Experience:

From:			To:

Name and address of employer and type of business
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Job Title and responsibilities
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B. Work Experience:

From:			To:

Name and address of employer and type of business
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Job Title and responsibilities
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C. Work Experience:

From:			To:

Name and address of employer and type of business
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Job Title and responsibilities
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D. Work Experience:

From:			To:

Name and address of employer and type of business
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Job Title and responsibilities
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E. Work Experience:

From:			To:

Name and address of employer and type of business
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Job Title and responsibilities
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 7.           Experience in Developing Countries: 
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7.1 Please give brief details of any experience in developing countries.
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8.            Spare Time Activities: 
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8.1 Please give brief details of your spare time activities and interests, 
(eg craft skills, sports, travel, etc). Include any voluntary work you 
have done, if any. 
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 9.           Education and Training: 
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Please tell us about any education and training that you have had since leaving school. 
Please do not use abbreviations. 

A. Education/Training		From:			To:

 Subject:

Name and address of place of study or training.
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Type of education or training(eg apprenticeship, degree, City & Guilds) and 
Qualification gained if applicable.
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B. Education/Training		From:			To:

 Subject:

Name and address of place of study or training.
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Type of education or training(eg apprenticeship, degree, City & Guilds) and 
Qualification gained if applicable.
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C. Education/Training		From:			To:

 Subject:

Name and address of place of study or training.
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Type of education or training(eg apprenticeship, degree, City & Guilds) and 
Qualification gained if applicable.
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D. Education/Training		From:			To:

 Subject:

Name and address of place of study or training.
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Type of education or training(eg apprenticeship, degree, City & Guilds) and 
Qualification gained if applicable.
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E. Education/Training		From:			To:

 Subject:

Name and address of place of study or training.
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Type of education or training(eg apprenticeship, degree, City & Guilds) and 
Qualification gained if applicable.
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____________________________________________________________________________

 10.           Why are you applying: 
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10. Please tell us briefly why you are applying for the job. If you are not responding 
to a specific job then why are you applying to be a development worker/health trainer?
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 11.           Your References: 
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References are taken up before interview. 
Please give the names and addresses of three people who will act as referees
Please give people who can be contacted easily
They must not be related to you
At least one of your references must be an employer, tutor or client if self-employed. 

A. Professional

Salutation:			Mr / Mrs / Miss / Ms / Dr

Name:

Address:

Country:

Postal Code:

Home Tel:

Work Tel:

Occupation:

How do they know You:

Can we contact them now:

B. Personal

Salutation:			Mr / Mrs / Miss / Ms / Dr

Name:

Address:

Country:

Postal Code:

Home Tel:

Work Tel:

Occupation:

How do they know You:

C. Other

Salutation:			Mr / Mrs / Miss / Ms / Dr

Name:

Address:

Country:

Postal Code:

Home Tel:

Work Tel:

Occupation:

How do they know You:

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 12.           Your Health: 
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You will need to have a full medical examination, normally given by your own GP, before you are finally accepted as a development worker/health trainer, but please answer these questions now. If you answer yes to any of the following questions please give brief details in the space provided. 

12.1 Have you ever had any serious physical     	Yes/No
        or mental illness, operation or accident?

Details:
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12.2 Are you taking any type of medication? 	Yes/No

Details:
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12.3 Have you ever received any medical               Yes/No
         or psychiatric treatment?

Details:
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Do you have any objection to vaccinations?      	Yes/No

Details:
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Doctor Name and Address:

Practice Tel: 

Our doctor may need to contact your doctor	Yes/No
In an emergency. Please indicate that we
may do so.

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13.	How did you here about Skillshare International:
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Recruitment event / Ex – development worker / VSO / ICD (CIIR)

International service / Newspaper article / Newspaper advert / Poster

Radio or TV / Exhibition / Recruitment talk / The internet

Other please state:

Please indicate that you have read and understood	Yes / No
This form and that the information you have given is
Correct, to the best of your knowledge.