StaffordshireUniversity Students’ Union
APPLICATION FORM
Please complete ALL sections of the application form.
You must also complete a Diversity Monitoring form and submit it with this application form.
Application for the position of:
SECTION 1: Personal Information
Please note that this information will only be used for HR use, and will not be used for short listing candidates.
Surname:
Forename(s):
Date of Birth:
Address for correspondence:
Postcode:
Phone Number (Home):
Phone Number (Business):
Phone Number (Mobile):
Email Address:
SECTION 2: Present Employment
Current post held:
Date started:
Salary:
Grade:
Benefits:
Notice required:
Employers Name:
Employers Address:
Postcode:
Brief details of present main duties/responsibilities of your post:
Reason for wanting to change job:
SECTION 3: Education
Please enter details of your education, starting with the most recent.
Date from:Date to:
Institution:
Qualification(s) including grades:
Date from: Date to:
Institution:
Qualification(s) including grades:
Date from: Date to:
Institution:
Qualification(s) including grades:
SECTION 4: Previous Employment
Please enter the details of your previous employment, starting with the most recent.
Date from:Date to:
Employers Name and Address:
Post held and main functions:
Reasons for leaving:
Date from: Date to:
Employers Name and Address:
Post held and main functions:
Reasons for leaving:
Date from: Date to:
Employers Name and Address:
Post held and main functions:
Reasons for leaving:
SECTION 5: Training
Please enter the details of your short courses, vocational and updating courses, starting with the most recent.
Date from:Date to:
Name of institution/organiser:
Title and nature of course:
Date from: Date to:
Name of institution/organiser:
Title and nature of course:
Date from: Date to:
Name of institution/organiser:
Title and nature of course:
SECTION 6: Professional Organisations
Please enter the details of any professional organisations you have membership with.
Admission Date:
Name of Institution/Organisation:
Class of Membership:
Admission Date:
Name of Institution/Organisation:
Class of Membership:
Admission Date:
Name of Institution/Organisation:
Class of Membership:
SECTION 7: Additional Information
Please include any additional information to support your application here. (Please do not include a CV).
SECTION 8: References
Please give the names and addresses of three persons to whom professional references can be made, including the capacity in which known (e.g. employer, colleague, friend).
Name and Title:
Address:
Telephone Number:
Capacity known:
Can they be contacted prior to interview? (yes or no):
Name and Title:
Address:
Telephone Number:
Capacity known:
Can they be contacted prior to interview? (yes or no):
Name and Title:
Address:
Telephone Number:
Capacity known:
Can they be contacted prior to interview? (yes or no):
SECTION 9: Rehabilitation of Offenders Act 1975, 1986
Please note that this information will only be used for HR use, and will NOT be used for short listing candidates.
Have you ever been convicted of a criminal offence? (yes or no):
If yes, please give details of the offence, including date of conviction:
Guidance note: You need not declare "spent" convictions unless the post for which you are applying is one covered by the Exceptions Orders 1975 and 1986. A post covered by the Exceptions Orders will be clearly indicated as such in the further details supplied to you. Where this is the case, then all criminal convictions must be declared.
SECTION 10: Health
Do you have, or have had, any medical condition which is relative to your ability to do the job for which you are applying? (yes or no):
If yes, please give brief details including absences from work during the last year:
The Union wishes to facilitate the appointment of persons with additional requirements wherever possible.
To help us give full consideration to such applicants, please indicate any additional requirements you have which you feel might be relevant to the post for which you are applying.
SECTION 11: Interview and Other Information
Where did you see this job advertised?:
In order to help us arrange a mutually convenient date, as we may not have agreed an interview date yet, please give details of any know dates in the future when you will not be available:
SECTION 12: Declaration
I declare that the information given in this application, and in any additional information I enclose, is true, with nothing having been omitted that would affect this application.
Signed:
Date:
Note: If submitting an electronic copy of this application form you will be asked to sign a copy if you are selected for interview.