Apply online

If you are interested in joining the team at City Response please download the application form below and return to:

Head Office:

Irving Court
Oldham Broadway Business Park
Telephone: 0161 947 3550



You can aslo send you application straight to us via the below online form

Other names in full
Gender male
Contact address:
Home phone
Work phone
Do you hold a current driving Licence?
Any endorsements:
If so, how many and what for?
Do you own a car?
If no, do you have the use of one?


Please list relevant educational or vocational qualifications

Professional or other qualifications (including membership of professional bodies – give dates)

Have you applied to City Response Ltd before? yes no
Do you have to the best of your knowledge, close friends or relatives working at City Response Ltd? yes no
If yes, please state name and location

Present or latest employment

Name and address of current/most recent employer

Nature of business

Brief description of duties

Job title:
Date started:
Date left (if applicable):
Current salary:
National insurance no.
Reason for leaving/wanting to leave:
How soon could you enter our employment if appointed?

Previous employment

Duration of appointment Name & address of employer/ organisation Nature of work Reason for leaving Salary if applicable


Please give the names and addresses of two referees, one being your present employer. No approach will be made without your permission. Wherever possible, employment references should cover your last three years of employment.

Reference 1

Reference 2

Other information

How would you describe your current health?
How many days sickness have you had over the past 12 months?
Over how many separate periods?
Please give details
Have you suffered from any serious illness or undergone any major operation? yes
If YES, give brief details and dates
Declaration of criminal record – please go to bottom of page to fill in.
For some positions, you will be required to complete a Criminal Records Bureau check


Please give a summary why your skills and/or experience are relevant to this position. Please indicate why you want this position.

Hobbies and leisure activities

Please give details.

To the best of my knowledge and belief, all the particulars I have given are true. I understand that any false statement may disqualify me from employment or render me liable to dismissal. I give my consent for City Response Limited to process the personal and sensitive information I have provided in this application. (Please note that in compliance with the Data Protection Act 1998, the information you have given to City Response Limited will not be disclosed to a third party without your permission).
Signature Date

STRICTLY PRIVATE AND CONFIDENTIAL City Response Ltd equality and diversity monitoring

We are committed to equality of opportunity for everyone. Monitoring our recruitment processes enables us to ensure that our workforce reflects the diverse communities of the local populations we work with.
Position applied for
Job ref. no.
Where did you see/hear about this vacancy:
Name of candidate:
Gender: Male
Date of birth

How would you describe your ethnic origin?

Please tick the appropriate box

White – British
White – Irish
White – Other
Mixed – White & Black Caribbean
Mixed – White & Black African
Mixed – White & Black Asian
Mixed – Other
Asian or Asian British – Indian
Asian or Asian British – Pakistani
Asian or Asian British – Bangladeshi
Asian or Asian British – Other
Black or Black British – Caribbean
Black or Black British – African
Black or Black British – Other
Other Ethnic Group

Thank you for completing this form, which is voluntary. If you choose not to answer, your application will not be affected. Do you have a disability?

Please read these notes before completing the question at the bottom of the page.

The definition of disability has expanded as a result of the Disability Discrimination Act 1995 and now many conditions are covered which weren't previously classified as a disability.

What is meant by disability?

The definition of a disability in the Act is a physical or mental impairment which has a substantial and long term adverse effect on the ability to carry out normal day to day activities.

What are considered normal day to day activities?

These are activities which involve functions which are carried out by most people on a fairly regular and frequent basis. For example:-

  • Mobility
  • Manual dexterity
  • Physical co-ordination
  • Continence
  • Ability to lift, carry or otherwise move everyday objects
  • Speech, hearing or eyesight
  • Memory or ability to concentrate, learn or understand
  • Perception of the risk of physical danger

Here are some examples of conditions which are now classified as a disability under the Disability Discrimination Act:-

  • Diabetes
  • Epilepsy
  • Depression
  • Severe disfigurements
  • Learning Disabilities
  • Dyslexia
  • Severe asthma
  • Arthritis

These are in addition to the more traditional forms of disability e.g. hearing/sight impairment, physical disabilities. The above are only examples and don't include all conditions which might be considered as a disability.

What about progressive conditions?

Progressive conditions, such as cancer, multiple sclerosis, muscular dystrophy and HIV infection are considered to be a disability from the moment the condition leads to an impairment which has some effect on ability to carry out normal day to day activities, as defined above.

Are any conditions not covered?

Yes. These are:-

  • Addiction to or dependency on alcohol, nicotine or any other substance (unless medically prescribed)
  • Seasonal allergic rhinitis e.g. hay fever

Please answer the following question:

Do you consider yourself to have a disability or long term health condition?

If YES, what is the nature of this disability?

And please describe (in relation to your disability)

Any reasonable adjustments which you feel we could make to the recruitment process to assist you in making your application

Any reasonable adjustments we would need to make to the job itself which would assist you to carry out this role if appointed.

Disfigurements such as tattoos or piercings

Declaration of criminal record – strictly private and confidential

City Response Ltd welcomes applications from ex-offenders as part of its Equal Opportunities Policy and a criminal record would not necessarily be a bar to obtaining a position. However, it is important that we check whether you have been convicted of a criminal offence (other than a spent conviction under the Rehabilitation of Offenders Act 1974) which may affect your suitability for this post.

This information is not passed to those short listing, which is purely based on your ability to do the job. If you are short listed a member of the personnel team may contact you to discuss any relevant information on this form to ensure it is possible for you to be considered for the post. The interview panel may wish to discuss this further if you are offered an interview.

Please complete this form

Have you ever been convicted of a criminal offence or given a formal reprimand, final warning or caution by the police?
yes no

If yes, please provide details

Date of offence

Nature of offence

Sentence or nature of police sanction

NB: Failure to declare a current conviction may disqualify you from employment or result in summary dismissal when the dishonesty comes to light.

I give consent for personal data divulged in applicants and forms for employment to be kept on files (both manual and computer) for recruitment, monitoring and employment purposes. Information will be stored securely in line with the Data Protection Act 1998


Working with children or vulnerable adults

Please note that anyone offered a post that requires working with children or vulnerable adults will be asked to apply for a disclosure from the Criminal Records Bureau, in addition to any information provided above. Any offer will be conditional on a satisfactory disclosure which you would receive a copy of.

Further information about the Disclosure Scheme can be found on

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