THE SARA LEE TRUST
TRUSTEE APPLICATION FORM
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Please complete this form using BLOCK CAPITALSin black ink. All sections must be fully completed inorder for your application to be considered. You may enclose your Curriculum Vitae as a supplement to the information given on this form but not as a substitute for it.

How did you find out about this vacancy? (If applicable please state in which publication/web-site you saw our advert):
Are you related to or associated with any employee, sessional worker, trustee, volunteeror patient of The Sara Lee Trust? YES / NO
(If YES please provide further details:

Personal Details

Surname: / Home telephone:
Forename(s): / Work telephone:
Address:
Postcode: / Mobile telephone:
Email address:
How would you prefer to be contacted?

Knowledge, Skills & Experience

Include in this section all relevant work experience, life experience, qualifications, skills or relevant training courses attended that may assist you in the role of Trustee
Please continue on a separate sheet if necessary
Supporting Information
Please state how your previous and present experience enables you to satisfy the essential and desirable criteriaon the person specification and provide details of any other skillsyou have that are relevant to the Trustee role. You may wish to continue on a separate sheet if necessary.
Please continue on a separate sheet if necessary

References

Please give the name, address, and occupation of two refereeswho can give relevant information regarding your knowledge, skills and experience for this role. One of these should be from your present employer or previous employer if you have worked in the past five years. Alternatively they should be people you know from a recognised profession or who have a good standing in the community. Any offer of appointment as a Trustee is subject to us receiving two satisfactory references.We are unable to accept references supplied by relatives.
Title:
Name:
Occupation/Capacity in which known:
Address:
E-mail:
Telephone Number: / Title:
Name:
Occupation/Capacity in which known:
Address:
E-mail:
Telephone Number:
Can they be contacted prior to interview?
YES NO
/ Can they be contacted prior to interview?
YES NO

Rehabilitation Of Offenders Act 1974 (Exceptions) Order 1975

Convictions will not necessarily be a bar to obtaining a post within the Sara Lee Trust. However because of the nature of the role for which you are applying, this position is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act, 1974. Applicants must declare information about convictions, cautions, reprimands and final warnings, which for other purposes are “spent” under the provisions of the Act. In the event of an offer of the post of Trustee any failure to disclose such convictions could result in dismissal by The Sara Lee Trust.
Have you ever been convicted, cautioned, reprimanded or given awarning for a criminal offence? YES / NO
Are you currently the subject of any police investigation and/or prosecution? YES / NO
Are you currently the subject of any investigation or proceedings by any regulatory body for complementary therapies or counselling? YES / NO
Have you ever been disqualified from practice/profession or required to practise it subject to specific limitations? YES / NO
Are you subject to any restriction, prohibition or limitation that would mean thatyou could not be considered for this role? YES / NO
If you have answered yes to any of the above questions - please give details on a separate sheet and enclose in a sealed envelope marked Confidential for the attention of the Chief Executive Officer and return with your completed application form.

Disclosure and Barring (DBS) Check

An Enhanced DBS Check will be required for successful candidates only as a condition of engagement as a Trustee. A DBS check details an individual’s criminal record, including convictions, cautions, reprimands and warnings held on the Police National Computer (PNC). These checks enable us as an organisation to make safer recruitment decisions by identifying candidates who may be unsuitable for certain work, especially those involving children or vulnerable adults. However, convictions will not necessarily be a bar to obtaining the position. There is a Policy & Procedure regarding the recruitment of ex-offenders available on request should you wish to see it.
NBPlease note that the process of obtaining a DBS check can take upto 6-8 weeks.
Data Protection
The information you provide in this form and on additional sheets will be used by a panel to evaluate your application. If you are unsuccessful your data will be securely retained for up to six months for all purposes relating to the selection process and will then be destroyed. If you are appointed this data will then form part of your personnel records.

Declaration

I DECLARE that thedetails and information given in this application form and any additional sheets are true and accurate. I understand that any misrepresentation found, or falsification and omissions discovered after an offer of the role of Trustee may lead to dismissal. I also understand that any offer of the role of Trustee is subject to two satisfactory references and receipt of a satisfactory DBS Check
Signature: Date:
Please Return this Completed Application Form To:
The Chief Executive Officer, The Sara Lee Trust, Jackson hall, Portland Place, Hastings TN34 1QN
/ SARA LEE TRUST
Equal Opportunities Monitoring Form

The following page will be detached from the rest of your application form and will not be used in the selection process, but may be used for monitoring purposes. The form will be part of your personnel record should you be appointed.

Name:
Job / Role Title:
Location:
Equal Opportunities
The Sara Lee Trust has an Equal Opportunities policy, the aim of which is to ensure that no job applicant or employee receives less favourable treatment or is disadvantaged by requirements which cannot be shown to be justified. In order to ensure that this policy remains effective, you are requested to answer the following questions (but it is not a legal requirement). This form will be treated in the strictest confidence and is designed for monitoring purposes only.
Date of birth:
Title – Please specify e.g. Mr / Mrs / Ms/ Miss / Dr / Other
Gender: MALE / FEMALE
Marital Status: SINGLE / MARRIED / CIVIL PARTNERSHIP / LIVING WITH PARTNER / OTHER
If other please specify:
ETHNIC ORIGIN (please tick) :
 White British
 White Irish
 Any other white background
 Mixed – White & Black Caribbean
 Mixed – White & Black African
 Mixed – White & Asian
 Any other mixed background
 Chinese /  Asian or Asian British – Indian
 Asian or Asian British – Pakistani
 Asian or Asian British – Bangladeshi
 Any other Asian background
 Black or Black British - Caribbean
 Black or Black British – African
 Any other Black background
 Any other background (please state)…………………
 Do not wish to give details

DISABILITY

The Disability Discrimination Act defines disability as ‘a physical or mental impairment which has a substantial long-term adverse effect on a person’s ability to carry out normal day-to-day activities’.

Do you consider yourself to be disabled in line with the above definition? / YES / NO
If yes, please state the nature of your disability

TrusteeApplicationForm – April 2016

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