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/