transforming mental health through creativity
Linskill Centre, Linskill Terrace, North Shields, Tyne & Wear, NE30 2AY
T: 0191 296 1156, E:
Registered in England & Wales No. 3266699
Charity No.1059103
North Tyneside Art Studio -Application Form
Post you are applying for
/Chief Executive Officer
Please note: In the interests of equality this section will not be seen by the interview selection panel. Please ensure you answer all questions.
Section 1. Personal detailsYour last or family nameYour first name
Your permanent home addressPostcode
Home telephoneWork telephone
Email addressMobile telephone
Disability: Under the Disability Discrimination Act (1995) a person is considered to have a disability if they have a physical or mental impairment which has a substantial and long term effect on their ability to carry out normal day to day activities. Based on this definition, do you consider yourself to be a disabled person? / YesNo
Why we ask this question:We need to ensure that people with disabilities are not disadvantaged and are given support if required. Your response to this question will not be seen by the interview selection panel.
Do you have support needs if asked to attend for interview? / Details:Work entitlement: Are you entitled to work in the UK? ………………………………….
Important information
Please ensure that the information you have provided is accurate and that you have not omitted any material facts. By completing this application form you agree that North Tyneside Art Studio can use the information during the recruitment process, including checking with third parties any of the information you have provided. You understand that if offered the post, North Tyneside Art Studio will retain the application form. If you are not successful you understand that all information will be destroyed four months after the recruitment process.
Declaration:
I accept that any offer of employment is conditional on true and accurate information, with no material omissions. I understand that if it is subsequently discovered that any statement is false or misleading, or references are not in line with agreed procedures, my contract may be terminated.
I declare that the information I have provided is true, accurate and complete. I understand that the contents of this application will form part of the Contract of Employment.
Applicant’s signature: / Date:If you are returning this form electronically a typed signature is acceptable and constitutes your personal certification that the details are correct.
Section 2: Education since age 13 years
Dates are NOT required
Schools
/Qualifications
College/University
/Qualifications
Further Education and
Formal Training
/Qualifications
Details of any courses attended
(Include professional membership and qualifications)
Do you have a full driving licence? Yes / No
North Tyneside Art Studio – Application form / CEO / March 18Page 1
Section 3: Current and Previous EmploymentPlease give details of your employment history OVER THE PAST 10 YEARS only. Start with your most recent employer. If you are not currently employed, please tell us about the last job you undertook. If you are currently self-employed please describe your work and supply a client’s name instead of an employer.
Dates are NOT required. Insert additional pages if necessary.
Employer’s name and address / Job Title / Salary / Main duties / Reason for leaving / How long in post?North Tyneside Art Studio – Application form / CEO / March 18Page 1
Section 4: Information relevant to the postPlease refer to the person specification and provide details on how you meet the essential and desirable criteria.Describe how your experience, skills, training and outside interests – such as voluntary work, leisure activities and hobbies - may be helpful to you in this position. You may insert additional pages if necessary.
Section 5: References
All appointments are subject to the receipt of two references that are satisfactory to NTAS.
References will only be sought following the offer of the post.
Please ensure you check with referees that they are willing and able to provide a reference for you. We can accept references only from the following:
Your situation / Reference required fromCurrently employed / / Your current line manager
Previously employed, now unemployed / / Your last line manager
Self employed / / Contractor
No previous employment / / A lecturer or teacher
Volunteering experience / / Your supervisor / line manager
Open references and references from family members are not acceptable.
Please complete the following details:
First referee / Second refereeFull name
Position held
Organisation name
Organisation address
Telephone
Connection with applicant
Help us to be a Fairer Employer
At North Tyneside Art Studio we try to be fair and even handed in everything we do, including recruiting staff. By completing this form you will be helping us to monitor our policy on fairness.
Please rest assured that the information you provide will be regarded as strictly confidential and will not be used by the selection panel. In fact, the panel never see this sheet, it’s separated from the application form and given to another member of the organisation who is not involved in the recruitment process.
1)How did you find out about this vacancy?NTAS website / Facebook
LinkedIn / Word of mouth
Online jobs site: Please specify
Other: Please specify
2)Gender
Male / Female
Described in another way
3)Ethnic Origin
White / Black or Black British
British / Caribbean
Irish / African
Other / Other
Asian or Asian British
Indian / Chinese
Pakistani / Other
Bangladeshi
4)Age
Under 20 / 50-59
20-29 / 60-65
30-39 / 66+
40-49
5)Disability
Do you consider yourself disabled? / Yes / No
Are you registered disabled? / Yes / No
If you are disabled, please specify the nature of your disability:
6)Caring Responsibilities
Are you the main carer for / An adult / A child
Thank you for completing this form.
North Tyneside Art Studio – Application form / CEO / March 18Page 1