Application for Employment– Confidential
Please email to
Alternatively, mail to:
Human Resources,
Brooksby Melton College,
Asfordby Road,
Melton Mowbray,
Leicestershire,
LE13 OHJ /
Post applied for:
Where did you see this vacancy:

1PERSONAL DETAILS

Title: / Forename: / Surname:
Home Address: / Postcode:
Home Telephone No: / Mobile No:
Daytime Telephone No: / Email:
National Insurance No: / Do you require a work permit?
(Seebelow) / YES /NO
A work permit is not required to employ a person who is a national of a country, which is a full member of the European Union (EU) or a national of another European Economic Area (EEA) country. In certain circumstances, it may not be necessary to obtain a work permit for a non-EU/EEA national, e.g. where permanent UK resident status has been granted by the Home Office or where the passport has been endorsed with a visa which places no restriction on employment in the UK.

2EMPLOYMENT DETAILS

PRESENT / LAST EMPLOYER (please delete as appropriate)

Name of company: / Job title:
Address of company:
Postcode:
Date of appointment: / Date left company (ornotice period):
Current (or last) salary: / Reason for leaving:
Brief description of duties

PREVIOUS EMPLOYMENT OVER LAST 10 YEARS (most recent first) - continue on a separate sheet if necessary

Name and address of employer / Job title / Date started / Date left / Brief description of duties / Reason for leaving

3 EDUCATION/ TRAINING DETAILS

RELEVANTBASIC / SECONDARY EDUCATION

Please include any qualifications for which you are currently studying (continue on a separate sheet if necessary)

School / College / Subject / Qualification / Grade
FURTHER/HIGHER EDUCATION

Please include any qualifications for which you are currently studying (continue on a separate sheet if necessary)

College / University / Subject / Date completed / Duration / Qualification / Grade
PROFESSIONAL QUALIFICATIONS/STUDIES (continue on a separate sheet if necessary)
Education Institution / Course Title / Date completed / Duration / Qualification rec’d

4PERSONAL STATEMENT

(please read the guidance notes before you complete this section)

Additional information

5REFERENCES

Please read the guidelines for applicants
REFERENCE 1:
This MUST be your current or most recent employer
/ REFERENCE 2:
This may be a previous employer or a character reference
Name: / Name:
Job title: / Job title:
Company Name: / Company Name:
Address:
Postcode: / Address:
Postcode:
Contact number: / Contact number:
e-mail address / e-mail address
I am happy for this referee to be contacted:
(please tick box) / I am happy for this referee to be contacted:
(please tick box)
Before interview / Before interview
On job offer / On job offer
If you are called for the next stage of the process please list any dates when you would be unavailable?
Rehabilitation of Offenders Act / Have you ever been convicted of a criminal offence? YES / NO
If YES please attach details on a separate sheet, including relevant date and offence committed. NB: Because of the nature of the work for which you are applying, this post may be exempt from the provisions of this Act. If exempt, candidates are not entitled to withhold information about convictions that, for other purposes, would be regarded as ‘spent’. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.
In the event of employment, any failure to disclose information about convictions will result in dismissal or disciplinary action.
Canvassing / CANVASSING OF STAFF OR GOVERNORS OF THE COLLEGE, EITHER DIRECTLY OR INDIRECTLY, IN CONNECTION WITH THIS APPLICATION WILL DISQUALIFY CANDIDATES
DECLARATION
The data on this application form will be used for the purpose of personnel administration and legitimate issues relating to employment. The college will observe the principles of the Data Protection Act 1998 at all times.
I confirm that the details given by me in this application are accurate. I understand that any false statement or failure to disclose information where required to do so will, if employed, render me liable to disciplinary action which may lead to dismissal.
Signed: ...... Date: ......

Send the completed form to:

Human Resources, BrooksbyMelton College, Asfordby Road, Melton Mowbray, Leics, LE130HJ.

or email to:

DIVERSITY MONITORING FORM

As public sector employers, colleges are required to collect details about their employees’ age, disabilities, ethnicity, gender, religious beliefs and sexual orientation. This is to ensure they meet their statutory requirements and to encourage the recruitment and development of a diverse workforce that represents the communities they serve. This information is collected to fulfil this obligation, and monitor our effectiveness of our equality and diversity work, and is an essential part of both these goals. The data we gather lets us know how the diversity of our workforce compares with the population in general as well as central government guidelines, and shows where adjustments need to be made to match these figures. It will also let us monitor, year on year, the progress of various diversity groups through their careers to judge whether everyone has the same opportunities open to them.

The information on this form is strictly confidential and the related data will be used as part of statistical considerations for planning and development purposes as mentioned above. Access to any related files will be compliant with the Data Protection Act 1998. It will be used by our Human Resources team to produce statistical information anonymously and in aggregate only.

Some examples of where diversity information is used:

Recruitment: To ensure the College is providing equal opportunities regardless of age, disabilities, ethnicity, gender, religious beliefs and sexual orientation.

Pay and Reward: To ensure the College is providing equal pay for equal tasks, independent of gender, ethic origin or disability.

Promotion: To ensure the College is providing equality of opportunity to be considered for promotion across the entire organisation.

Learning and Development: To ensure the College is providing equality of opportunity to be considered for training and career development across the entire organisation.

Please complete the information below:

Post applied for:
First name:
Surname:
Date of birth:
Full time/Part time position

National Identity and Ethnicity

Which nationality do you most identify with?

British or Mixed-British
English
Irish
Scottish
Welsh
Prefer not to say
Other national identity (please specify)

Which ethnic group do you most identify with?

The categories below are based on the broad categories used in the 2001 Census as recommended by the Equality and Human Rights Commission (EHRC). Please indicate with an X in the relevant box.

White / British
Irish
Any other White background (please specify)
Mixed / Black Caribbean and White
Black African and White
Asian and White
Any other Mixed/multiple ethnic background (please specify) (pleasespespespespecify specify)
Asian or
Asian British / Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background (please specify)
Black or
Black British / African
Caribbean
Any other Black background (please specify)
Any other ethnic background (please specify)
Prefer not to say

Religion and Beliefs

What is your religion or belief?

Buddhism / Judaism
Christianity / Sikhism
Hinduism / None
Islam / Prefer not to say
Other philosophical belief or religion (please specify)

Sex And Gender

How do you identify yourself?

Female / Male / Prefer not to say

Which of the following statements best describes you?

Heterosexual / Gay / Lesbian / Bisexual / Prefer not to say

Disability

A disabled person is defined in the Disability Discrimination Act as someone with a physical or mental impairment that has a substantial and long-term impact on their ability to carry out day to day activities. Examples are: mobility, manual dexterity, speech, hearing, seeing and memory.

The definition also covers HIV, Multiple Sclerosis and Cancer from the time of diagnosis, and progressive conditions from the point at which they have an impact on day-to-day activities.

Having read this do you consider yourself to be covered by the definition?

Yes / No / Prefer not to say

If yes, which would you say is the most affected:

Eyesight / Mobility
Hearing / Manual dexterity
Speech / Physical coordination
Progressive condition / Ability to learn, understand or remember
Ability to lift, carry or move everyday objects / Prefer not to say
Specific arrangements required (detabelow) / Statement of Disability (details below)

If you have a disabilityplease advise us,if you've not already done so, so that reasonable adjustments can be made if required.

DECLARATION

I understand that the information I have provided above will be recorded and processed on the HR database in accordance with the Data Protection Act 1998 and the data protection principles contained therein.

Name: / Date:
Signed:

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