THE WELLBEING INITIATIVE CANDIDATE APPLICATION FORM
Please fill in the following application form to the best of your ability, please put as much detail as you possibly can, then please return to the address overleaf.
Name:		Tel No:
Address:		Date of Birth:
Town:		Age:
Educational History
Secondary School Attended:		Certificates or Achievements Gained:
Dates Attended:
Further Education
College/Evening Classes:		Certificates or Achievements Gained:
Dates Attended:
Employment History (Please include any Voluntary work you have been involved in)
Name of Organisation		Period of Employment	Outline of Duties
It would help us to know a little about you and your disability, health condition, in order that we can make any special arrangements required for you when attending an interview and for any future training needs.
1. What disability/health condition do you have?
2. Do you have any mobility problems?		Yes	No
3. If the above answer is yes, please give more details.
4.Are you able to use public transport?		Yes	No
5. Do you require assistance with childcare costs?		Yes	No
6. If the above answer is Yes, how many children do you have and what ages are they?
7. Do you have any problems with literacy or numeracy?
8. If the above answer is yes, please give more details:
9. How did you hear about Wellbeing?
Please use the space below to tell us a little about yourself, your hobbies and interests and why you would like to join The Wellbeing Initiative:
Applicants Signature:		Date:
All of the above information will be treated with the strictest confidence. Please return your completed application form to:
Mr W McFarlane The Wellbeing Initiative 1st Floor, Clydeway Centre 45 Finnieston Street GLASGOW G3 8JU