Application Form - Youth & Outreach Worker
Closing date: Tuesday, 1st December 2026
There is also a paper application form available from contact@elimblackpool.org.uk
*Required
Surname* Title and First names*
Contact details
Address*
Address
Town*
Postcode*
Email*
Mobile
Home
Work
May we, with discretion, phone you at work?
Yes
No
Date of birth
Marital status
Do you consider yourself a disabled person?
Yes
No
If yes, will you need any special arrangements to be made to assist you at the interview? Please specify:
Convictions
Have you ever been convicted of a criminal offence under the Rehabilitation of Offenders Act 1974?*
Yes
No
Nature of offence
Date of conviction
Penalty
(Please email additional sheets to contact@elimblackpool.org.uk as required)
Education, Qualifications and training
Please provide details of your education and training together with any qualifications you have received.
(1) Secondary education, further education, degree, training schemes, professional memberships
From Month/Year
To Month/Year
Part time
Full time
Qualifications
(2) Secondary education, further education, degree, training schemes, professional memberships
From Month/Year
To Month/Year
Part time
Full time
Qualifications
(3) Secondary education, further education, degree, training schemes, professional memberships
From Month/Year
To Month/Year
Part time
Full time
Qualifications
Current employment
(1) Name and address of employer*
Job title*
Type of business*
Reason for leaving (if applicable)
Salary/wage*
Other benefits
Date of appointment*
Notice required*
Employment history
(1) Job title
Date started:
Date finished:
Reasons for leaving:
(2) Job title
Date started:
Date finished:
Reasons for leaving:
(3) Job title
Date started:
Date finished:
Reasons for leaving:
(4) Job title
Date started:
Date finished:
Reasons for leaving:
(Please email additional sheets to contact@elimblackpool.org.uk as required)
Why are you applying for this post?*
Experience and skills
Focusing on the essential criteria of the enclosed person specification, please state what knowledge, skills and experience you have which are relevant to the job. Include information about your paid employment and any voluntary work you have done which you feel is relevant to this post.*
Approach
Please describe your initial thoughts as to how you think you would approach fulfilling the requirements of this role.*
Is there anything else you wish to add in support of your application?
Personal faith
Please provide a brief account of your Christian testimony.*
References
Please give the name, address and telephone number of two referees who can broadly represent your professional work and personal interests. This should include your current or most recent employer, and may include your minister if relevant. Please note that no-one included in short listing for interviewing is permitted to act as referees for candidates applying for this post.
Name*
Address*
Telephone*
Position*
Relationship to applicant*
May we sensitively contact this referee prior to interview? Yes
No
Data protection
The information or data which you have supplied on this application form will be processed and held on computer and held on your personal records if you are appointed. The data may be processed by Gatehouse Church for the purposes of equality monitoring, compiling statistics and for the keeping of other employment records. By signing and returning this application form you will be deemed to be giving your explicit consent to the processing of data contained in it, including any information which may be considered to be sensitive personal data.
Declaration
I declare that the information contained in this form is true and accurate. I understand that if it is subsequently discovered that any statement is false or misleading, I may be dismissed from employment with Gatehouse Church.
I give consent to Gatehouse to store my information in line with GDPR and data protection laws.
11/11/2026