Long Term Unemployed (LTU) Job Creation Programme Glasgow – Third Sector Application and Eligibility Form

Vacancy Applying For (Step 1 of 10)

Job Title:*

Job No.:*

Employer:*

Referrer Details If Applicable (Step 2 of 10)

Name:

Organization:

Office:

Address:

Phone Number:

Email:

Applicant Details – MUST Be Glasgow Resident (Step 3 of 10)

Title:

First Name:*

Surname:*

National insurance No:*

DOB:*

Age:*

Mobile Number:*

Home Tel. Number:

Email:*

Address:*

Applicant Eligibility (Step 4 of 10)

All applicants must be Glasgow residents, aged 25+ and 12 months or more out of work and not in education or training who would, without significant investment, struggle to secure/sustain employment AND who have one or more of the additional barriers listed below

Please complete the following:

Current Employment Status (please tick one)

Long Term Unemployed

12 months – 2 years 2 years – 5 years Over 5 years never been employed

Additional Barriers To Employment – Tick All That Apply (Step 5 of 10)

WORK EXPERIENCE (start with the most recent first) (Step 6a of 10)

To All Applicants - Please complete ALL sections

Employer/Placement provider Incl. Volunteering:*

Job Title and main duties*

Reason for leaving:*

WORK EXPERIENCE (If Applicable) (Step 6b of 10)

Please complete ALL sections

Employer/Placement provider Incl. Volunteering:

Job Title and main duties

Reason for leaving:

EDUCATION AND TRAINING (start with most recent first) (Step 7a of 10)

School/College/Training Provider Attended:*

Qualification (s) achieved or training course details:*

EDUCATION AND TRAINING (If Applicable) (Step 7b of 10)

School/College/Training Provider Attended:

Qualification (s) achieved or training course details:

ADDITIONAL INFORMATION (Step 8a Of 10)

Use this section to tell us why you want the job, tell us about your personal qualities
in relation to the job and link your previous experience and skills to the job role*

ADDITIONAL INFORMATION (Step 8b Of 10)

Do you require any particular arrangements to be put in place should you be invited to interview. If YES, please give details.:

REFERENCES (1) (Step 9a of 10)

Please supply details of 2 individuals who, if needed, can provide a reference for you

Full Name:*

Organisation:*

Position:*

Address including postcode:*

Tel. No:*

Email:*

REFERENCES (2) (Step 9b of 10)

Full Name:*

Organisation:*

Position:*

Address including postcode:*

Tel. No:*

Email:*

DECLARATIONS (Step 10a of 10)

To be completed by referrer if applicable

I can confirm that the above named is eligible to participate in the Long Term Unemployed (LTU) Jobs Creation Programme and can evidence their eligibility

Print Name:

Date:

Upload Referrer’s signature:

DECLARATIONS (Step 10b of 10)

To be completed by applicant

I can confirm that I, the applicant, am eligible to participate in the Long Term Unemployed (LTU) Jobs Creation Programme and can evidence my eligibility. I agree for the employer to forward my application and any documentation provided by me to evidence my eligibility to GCVS/Move On to confirm my eligibility for the programme should I be successful at interview and for these details to be shared with Scottish Government.

Print Name:*

Date:*

Upload Applicant signature:*