ACTION HEALTH APPLICATION FORM
If you feel you could work with Action Health, please fill in the following application form.
 

Please complete all sections so that all applicants are given equal consideration. CVs will not be considered.
In order to be able to spend time on completing this form, you may want to complete it while offline, reconnect and then submit the form.

The size of the boxes is not necessarily a guide to how much information we require. Please include as much information as you feel is relevant to the question and your experience/qualities.

Please note, information from this form will be stored on computer.

About You:

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 Health Trainer?
1.4 Salutation:
1.5 Full Name:
1.6 Email Address:
1.7 Postal Address:
Country:
Postal/Zip Code:
Tel Home:
Tel Work:
1.8 Date of Birth: Day Month Year
1.9 Status: Since:
1.10 Citizenship:
1.11 Do you hold a current driving licence? Yes No

Couples:

Please note that if you are both applying to go overseas as health trainers it may not be easy to place you both in the same area. Please complete an application form each.

Partners who want to go overseas but who are not applying to become health trainers will be invited to attend the selection process. Flights and medical cover may be provided for partners who are not health trainers. We shall try to indicate in the job descriptions whether or not accommodation is suitable for accompanied health trainers.

2.1 Is you partner applying to become a health trainer? Yes No
2.2 If so, what is their name?
2.3 If not, do you intend to live together overseas? Yes No

Children:

In certain circumstances Action Health is able to recruit people with children. In which case, Action Health 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

Finance:

Please think carefully about the financial implications of working as a health trainer.

You will be paid an allowance in the currency of the country you work in.

The country 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 if you become a health trainer?
5 Please tell us on which dates you are not available for interview

6. Your Work:

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.

From
month/year		 To
month/year		 Name and address of employer
and type of business		 Job title and responsibilities

7. Please give brief details of your spare time activities and interests, (eg craft skills, sports, travel, et cetera) Include any voluntary work you have done, if any.

8. Education and Training:

Please tell us about any education and training that you have had since leaving school Please do not use abbreviations

From
m/y		 To
m/y		 Name and address of place of study or training Subject Type of education or training (eg degree, diploma) and qualification gained if applicable Full/
Part-time

9. 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 an health trainer?
10. Please give brief details of any experience overseas
11. What aspects of your professional (or other) experience to date do you think are most relevant to a training post overseas
12. If there is any additional information relevant to this form that you would like to submit, please do so here stating the appropriate question number.

13. Your References:

References are taken up before interview. Only give your current employer if we may contact them now.
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.

Professional
Salutation:
Name:
Address:
Country: Postal/Zip Code:
Home Tel: Work Tel:
Occupation:
How do they know you?:

Personal
Salutation:
Name:
Address:
Country: Postal/Zip Code:
Home Tel: Work Tel:
Occupation:
How do they know you?:

Other
Salutation:
Name:
Address:
Country: Postal/Zip Code:
Home Tel: Work Tel:
Occupation:
How do they know you?:

14. Your Health:

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

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

Are you taking any type of medication? Yes No

Have you ever received any medical or psychiatric treatment? Yes No

Do you have any objection to vaccinations? Yes No

Our doctor may need to contact your doctor for more information.

Check this box to entitle us to do so and fill in the contact details opposite

Doctor's Name:
Address:


Practice Tel:

How did you hear about Action Health? Please tick Relevant boxes.

Recruitment leaflet Ex-development worker VSO
ICD (CIIR) International Service Newspaper article
Newspaper Advert Poster Radio or TV
Exhibition Recruitment talk Other article
The Internet Other, please state

I have read and understood this form and the information I have given is correct, to the best of my knowledge

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