Casual Operational Engagement Form

KEELE UNIVERSITY

CASUAL OPERATIONAL ENGAGEMENT FORM

INSTRUCTIONS FOR COMPLETION:
This form is designed to be completed in Microsoft Word.

To enter information into any of the yellow fields please click on the grey box within that field and type your information in.
Some fields require a box to be ticked, in order to do this please double click the box of your choice and click the option “checked” in the dialogue box which appears.
The Equal Opportunities form at the end will be separated from your application.

SECTION ONE

1. Vacancy Details

Job Title / Post Reference Number
Unit/ Work Location / Closing Date

2. Domestic Assistant Vacancies ONLY

What time can you start work? (Please circle all that apply):
7.00am 8.45am 9.30am 5.30pm

3. Personal Details

Surname/Family Name / Preferred Title
Please select / Mr Mrs Ms
Miss Other
Forename(s) / Home Address
Home Tel No. / Post Code:
Mobile Tel No. / Do you have a full driving licence? / Yes NoPending
(Please give details of any endorsements on a separate page)
Email address

4. Eligibility to work

Prior to commencement of your engagement, the University is legally obliged to ask you to provide evidence of your right to work in the UK. For details please contact the HR Team on (01782) 733694.
1) Are you a UK/ European Economic Area (EEA) National? / Yes No
2) If you answered ‘no’ to question 2 please indicate what type of immigration authorisation you hold which would enable you to take up this appointment-

SECTION TWO

1. Education

1.1 Secondary, Further and Higher Education – GCSE, CSE, “O” Level, A-Levels, GNVQ’, degree or equivalent.

Please use the additional information section or on an additional sheet if necessary
Name of Organisation / Qualification level / Subject / Grade / Date gained (or expected)

1.2 Other Qualifications.

Please list any other relevant qualifications including membership of professional societies and/or associations.

1.3 Relevant Training (attended in the last three years)

Course Title & Content / Organising Body / Date Attended

2. Employment

2.1 Present or most recent employer

Post Title
Dates: from and to / Salary/ Wage
Other benefits / Notice required
Name and address of employer / Reason for leaving
Brief details of present main duties/responsibilities of your post

2.2 Previous Employment

Dates Employed
From
Month/Year / To
Month/Year / Employers Name & Address / Post Title / Brief Descriptions of duties

3. Supporting Statement

Please use this section to state your reasons for applying for this post. Outline the skills & experience you have gained, either in paid work, unpaid/voluntary work, work at home, through your studies, through your leisure activities which you think are relevant to the job for which you are applying, and which you believe makes you suitable for the post. Be sure to include any relevant achievements. If you require more space please attach extra pages or use the additional information section.

4. Availability to Work

Please indicate in this section any time of year that you are unable to work.

5. Confirmation of Details

I confirm that all the information given is correct to the best of my knowledge and that all the questions related to me have been accurately and fully answered.

I give my consent for Keele University to record, process and validate my personal information and sensitive personal data in line with the Data Protection Act 1998 and all other legislative provisions. My consent is conditional upon KeeleUniversity complying with its legal duties and obligations relating to the recording and use of this information.

Signature Date

7. Additional Information

Please note:

All wages will be paid on a monthly basis into a Bank or Building Society account.

Applicants may be required to undergo a medical examination by the University Occupational Health Department.

If any section of this form is not relevant to you please write ‘N/A’ – ‘not Applicable’’.

Have you attached any sheets of additional information? Yes`No

If Yes, How many pages have you attached?Pages

Thank You