Brentnall House, 32 Vicarage Street

Brentnall House, 32 Vicarage Street.

North Walsham NR28 9DQ

T: 01692 407509

W: wwwgriffon.org.uk

Company No; 5020249

Registered Charity No; 1104364

Job Application Form Confidential

Please complete using black ink or type

Position applied for

Personal Details

Title (Mr./Mrs./Ms./Miss) Forenames Surname
Home Address
Postcode
Date of Birth
Telephone: Evening
Daytime
If at work, may we contact you there? yes
No
When would you be unavailable for interview?
Do you have a current driving licence? Full Provisional

How much notice of leave must you give your present employer?

References

Please give details of your current and most recent employers from whom confidential references may be obtained. These may be requested before interviews unless you place an ‘X’ in appropriate box.

Name
Address /
Name
Address
Occupation / Occupation

Additional Information

Have you been convicted of any criminal Offences which are not yet ‘spent’ under the Rehabilitation of Offenders Act?
Yes No / If so, please specify the dates and details of any convictions or cautions.

Reason for Application

Please state why you are applying for this post. Give details, experience and knowledge that match the Person Specification and Job Description details. You are welcome to give relevant examples from your private life as well as your working life. Continuation sheet(s) can be attached.

Reason for Application cont.

Are you related
to any Trustee Yes No
or EMPLOYEE
of Griffon Area
Partnership
If so, please state their name(s) and relationship.
How did you find out about this vacancy? (Please state any publication in which you found it)

I certify that to the best of my knowledge the information given in this application is true.

Signed
Please note that you will be asked to sign a copy of your application if invited for interview.
Date

Thank you for taking the time to complete this application form. Receipt of your will not be acknowledged, but every applicant will receive a reply. Please send the completed form to address as at the top of the application form.

Equal Opportunities Policy and Monitoring Form

Confidential

Please read this before completing the form and return to the address stated below.

Policy
It is the Griffon Area Partnership’s policy to recruit the most suitable candidate for the job. Selection for recruitment, promotion and training will only be made on merit. The Griffon Area Partnership will not discriminate against any person because of race, colour, creed, ethnic origin, sex, marital status or disability.
Monitoring
Employers are strongly recommended by Codes of Practice to monitor the implementation and performance of their Equal Opportunities Policy. In order to help us monitor our performance please complete the information below and return it with your application. Please tick one box in each section below.
This information will be used for monitoring purposes only. It will be treated as strictly confidential and will not be disclosed to any manager responsible for recruitment.
Full Name
Please tick the relevant box
Married Single / Please tick relevant box
Male Female
Ethnic Origin – Please tick one box
White
British Irish
Mixed
White and Black CaribbeanWhite and Black African White and Black Asian
Asian or Asian British
Indian Pakistani Bangladeshi
Black or Black British
African Caribbean
Other Ethnic Groups
Chinese
Any other group not listed above (please write in) ______
PLEASE SEE OVERLEAF BEFORE SIGNING THIS FORM
I understand that the information I have supplied above and overleaf will be retained and used for Equal Opportunities monitoring purposes and is correct to the best of my knowledge.
Signed
Please note that you will be asked to sign a copy of your application id you are invited for interview
Date

Company No; 5020249

Registered Charity No; 1104364

Disability:
Do you have a disability within the meaning of the Disability Discrimination Act 1995? Yes No
(see below for condition)
Type of disability/condition (please describe if you are happy to do so) ______
If your disability requires any special arrangements when attending an interview, please specify below
______

DEFINITION OF DISABILITY

The Disability Discrimination Act 1995 defines disability as “a physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities”.
The definition includes physical and mental impairment, including sensory and learning disabilities, which meet the substantial and long term adverse effect criteria. Mental conditions are only included when they are clinically recognised. Some conditions are specifically excluded, eg. Hayfever. To have a substantial and adverse effect, impairment must be more than minor or trivial and go beyond normal differences between people. To be long-term, the impairment must have had that effect for at least 12months or likely to recur.
Day to day activities include the things most people do on a regular basis such as getting dressed. To have an adverse effect, the impairment must have an effect on the following:
. Mobility . Speech, hearing or eyesight
. Ability to lift, carry or move objects . Memory, or ability to concentrate, learn or understand
. Manual Dexterity . Recognition of the risk of physical danger
. Physical Co-ordination . Continence
The following are some examples of impairments or long term conditions that could be considered as a disability under this definition. It is not exhaustive, but intended to give you a guide as to what might be included:
. Limited physical mobility . Dyslexia . Severe Allergies
. Upper Limb Disorders (eg RSI) . Severe Facial Disfigurement . Heart/Circulation complaints
. Long term back/ neck problems . Epilepsy . Clinical Depression
. Arthritis . Diabetes . Schizophrenia
. Hearing problems (even if corrected by aid) . Chrohn’s Disease . Manic Depressive (Bi-Polar) illness
. Speech impairment . Muscular Dystrophy . Learning disabilities
. Sight impairment (not where correct with lens) . Multiple Sclerosis . Severe Agrophobia
If you are not sure whether your impairment is a disability as defined by the Act, the following chart may guide you:
Does the impairment have a substantial adverse effect?

NO
YES
Does the impairment have a long-term adverse effect?

NO
YES
Does the impairment effect normal day to day activities?

NO
YES
Your impairment is probably defined as a disability for these purposes.
NO
Your impairment is not a disability for these purposes