Application Form PART 1 PERSON AL DETAI LS

Application Form
Position applied for
Vacancy reference
Applicant reference
(office use only)
PART 1
PERSONAL DETAI LS
Last name
First name(s)
Title
Mr / Mrs / Ms / Miss / Dr / Other:
Current address
Post code
Home telephone
Mobile telephone
Work telephone
E-mail address
Immigration status
Are you currently eligible for employment in the UK?
(If you are shortlisted for this post you will
be asked to provide identification
documentation in accordance with the
immigration, Asylum and Nationality Act
2006)
UK
National
Insurance
Yes
No
If yes, please write in any conditions (e.g. end date, Visa
type):
number
1
Disability
The Equalit y Act 2010 def ine as a ‘Physical or menta l impairment which has substantia l
and long -term adverse eff ect on a person’s abilit y to carr y out normal day-t o-day
activities.
Do you have a disability as defined by the Equality
Act 2013
Yes
No
Easton & Otley College are ‘positive about disabled
people’.
Yes
If you meet the essential criteria of the post would
you like to be considered for a guaranteed interview
under this scheme?
Do you have any requirements that would aid you at
interview or at work?
Yes
No
No
If Yes, please give details:
Disclosure of Criminal Convictions and Police Cautions, Warnings and
Reprimands including spent times
Unless documentation provided in this pack states t o the cont rary, this post is exempt
f rom the provisions of section 4( b) of the rehabilitation of off enders act by virtue of the
rehabilitat ion 1974 (exemptions) order 1975 because of the nature of work involved.
You ar e theref ore not entit led to wit hhold i nf ormation and in the event of employment,
any f ailure to disclose such convictions could result in dismissal or disciplinar y action.
W e will be requir ed to obtain a Disclosure Barr ing Ser vice Check f or individuals
appointed to certain posts.
Have you ever been (i) cautioned (ii) convicted of a
criminal offence or (iii) do you have any hearings Yes
pending?
No
If ‘YES’ please provide further information in a separate document
2
PART 2
EMPLOYMENT DETAILS
Most recent Employment details
Present/Last Employers Name Position Held:
and Address:
From:
Salary (£):
Until:
Notice period:
Reason for leaving:
Duties, Responsibilities, Major Achievements etc:
CAREER HISTORY
Starting with the pr esent, please give details of your career histor y (please list most
recent f irst and provide a minim um of 10 years histor y where applicable). As well as
employm ent, please include any periods of voluntar y work, travel, career breaks and
unemployment. Please cont inue of a separate piece of paper if necessar y.
Start
date
End
date
Employer
Job title and key responsibilities
Reason
for
leaving or notice
period
(where
applicable)
3
EDUCATION, QUALIFICATIONS & TRAINING
Education and Trai ning
Starting with the most recent, please give details of your education and any training which is relevant to
your application. We may ask you to produce qualification certificates if we ask you to come to an
interview. Please continue of a separate piece of paper if necessary.
School/College/University/
Institution, including address.
Start
date
End
date
Qualification level (if
Subject
applicable)
Grade
(if
applicable)
Other Training and Short Courses
Organising Body
Course and/or Subject
Date obtained
Professional Bod y Membership
Please give details of any professional body membership which you hold.
Professional body
Membership level
Start date
Professional body
Membership level
Start date
4
PART 3
SUITABILITY FOR THE ROLE / ADDITIONAL INFORMATION
Please review the requirements of the job description and person specification and provide evidence of
how you meet these, using specific examples within the area below.
(Please use this space to continue with your supporting statement if necessary)
Please provide details of two people who will each provide a work-related or academic reference. One of
these referees must be your current or most recent employer. If you do not have a current or recent
employer, please provide details of your lecturer/course tutor/unpaid work employer etc.
First reference
Name
Character or Business Reference
Position
Address
Telephone number
E-mail address
Can we contact this referee before the interview?
Yes
No
Yes
No
Do you have any business or other interests, which
would conflict with the duties of this post?
Yes
No
Second reference
Name
Character or Business Reference
Position
Address
Telephone number
E-mail address
Can we contact this referee before the interview?
Do you hold a current clean driving license
Yes
No
Yes
No
Do you have use of a motor vehicle?
Post Specific
For Academic Posts
Please list the subjects you are able to t each, givin g an indication of the level of work.
Subject
Level Of Work
For Part- Time Posts
Please t ick availability.
Availability Monday
AM
Tuesday
Wednesday Thursday
Friday
Saturday
Sunday
PM
APPLICANT DECLARATION
I certify to the best of my knowledge, the information I have given on these application forms is true and
accurate. I understand that any offer of employment is strictly subject to satisfactory references, medical
clearance, college checks and Criminal Records Bureau disclosure, and that any false statement would
render me liable to termination of employment. I understand that information given in this application will
be held on computer and processed in accordance with the Data Protection Act 1998 and that I consent
to the storage and use of such information for employment purposes.
Applicants Signature
Date
Please note the College will only accept applications on the standard College form.
For roles based at Easton campus, please return your application to: HR Department, Easton &
Otley College, Easton, Norwich, NR9 5DX.
For roles based at Otley campus, please return your application to: HR Department, Easton &
Otley College, Charity Lane, Otley, Suffolk, IP6 9EY
Please ensure correct postage by referring to the Post Office if necessary.
Equal Opportunities in Employment and Advertisement Monitoring
Vacancy reference
Post title
Applicant Name
Advertising Source
Where did you first learn about this vacancy?
Newspaper (please specify)
Jobs24
College Website
Job Centre
TES
FE Jobs
CTP (RightJob)
Other (please specify)
Are you a relative, partner or close friend of any member of the staff or corporation?
Yes
No
If Yes:
Name:
Relative:
About You
Gender:
Date of Birth:
(DD/MM/YYYY)
Nationality:
(Country or
Origin/Citizenship)
Religion:
(Delete as applicable)
Atheist / Baha’i / Buddhism / Roman Catholic / Christianity /Hinduism
Jainism / Judaism / Parsi / Rastafarianism / Sikhism / Zoroastrian/
Islam/ Prefer not to disclose
Other please specify:
Sexual Orientation:
(Delete as Applicable)
Marital Status:
(Delete as Applicable)
Heterosexual / Gay / Lesbian / Bisexual / Prefer not to disclose
Civil Partnership / Divorced / Married / Partnered / Single /
Widowed/ Separated / Prefer not to disclose
Ethnic Origin
Please Circle appropriate number
What
is
background?
your Asian/Asian British
11
Asian/Asian British Bangladeshi
12
Asian/Asian British Indian
13
Asian/British Pakistani
14
Asian/Asian British and other
Asian Background
Black/Black British
15
Black/Black British African
16
Black/British Caribbean
17
Black/British any other Black Background
Chinese
18
Chinese
Mixed Race
19
Mixed- White & Asian
20
Mixed- White & Black African
21
Mixed- White & Black Caribbean
22
Mixed- Any other Mixed Background
White
23
White- British
24
White- Irish
25
White- Any other White Background
98
Any Other
99
Not Known/Not Provided
Disabilit y
The Equalit y Act 2010 def ine as a ‘Physical or mental impairment which has substantial
and long -term adverse eff ect on a per son’s abilit y to carr y out normal day-t o-day
activities.
Do
you
regard
yourself as in any way Yes
disabled?
If yes:
(Delete as applicable)
No
Prefer not to say
Learning Difficulty / Mental Ill Health / Physical Impairment/
Unknown / Rather Not Say
Equal Opportunities in Employment and Advertisement Monitoring
The College seeks to employ a workforce, which reflects the diverse community at large, because we value the
individual contributions of all people. We will treat all employees with respect and dignity and provide a working
environment free from unlawful discrimination, harassment or victimisation. To this end, within the framework
of the law and best personnel practice, we are committed, wherever practicable, to achieving and maintaining a
workforce, which broadly reflects the local community.
The College will not tolerate any form of behaviour or activity that discriminates on the grounds of gender,
gender reassignment, marital status / civil partnership, pregnancy and maternity, family responsibilities, sexual
orientation, colour, race, nationality, religion and belief, ethnicity, disability, age and unrelated criminal
convictions.
No employee or job applicant should be disadvantaged or treated less favourably because of conditions or
requirements which cannot be justified and the college will seek to make reasonable adjustments to its
arrangements and premises with a view to avoiding any disadvantages for people with a disability. Action will be
taken to ensure that individuals are treated equally and fairly and that decisions on recruitment, selection, pay,
training, promotion and career management and on the termination of employment are based solely on objective
and job related criteria.
The College will ensure that all members of the “College Community” are not unjustifiably disadvantaged with
regard to the college environment/ physical access, college, publicity, marketing and admissions, student
guidance, curriculum, assessment, discrimination and harassment.
For more information please go to:
www.easton-college.ac.uk/about-easton/equality-diversity/