APPLICATION FOR SUPPORT STAFF APPOINTMENT /
Office Use Only:
Application No:
Post Title: / Post Number:

(Please type or complete in Black Ink)

PERSONAL DETAILS

NAME IN FULL: / TITLE:
(Surname first, block capitals. Please underline the name you would like to be known by.)
PREVIOUS OR OTHER NAME(S): / D.O.B.:
ADDRESS:
POSTCODE:
National Insurance Number: / E:mail Address:
Tel. No. (inc. STD Code) / Home: / Work:
PRESENT EMPLOYMENT(IF APPLICABLE)
NAME AND ADDRESS OF EMPLOYER: / Job Title:
ADDRESS: / Date of Appointment:
Present Salary:
Any Additions:
POSTCODE: / Period of Notice:
Reason for wish to leave:
Brief outline of duties:

Candidates called for interview will be required to bring the following original documents to the interview for verification purposes: I) Birth Certificate or Passport and II) Certificates of Academic and Professional Qualifications.

DETAILS OF SECONDARY EDUCATION

School/College attended:
Dates From/To:
Qualifications:
Courses and relevant Training
(Include Examinations and results where applicable) / Dates
Membership of Professional/Technical Bodies
Institute or Association / How obtained
(e.g. Examination or Election) / Date / Grade of Membership

GENERAL INFORMATION

Do you have a full driving licence? /

YES

/

NO

Do you have any current endorsements? /

YES

/

NO

PREVIOUS EMPLOYMENT (Most recent appointment first)

PLEASE DO NOT LEAVE GAPS IN EMPLOYMENT – IF UNEMPLOYED/TRAINING ETC WRITE THESE ON THE FORM

1. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
2. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
3. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
4. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
If your employment goes back further, please use the continuation sheet enclosed.
Interests/Hobbies:

REFEREES

Two referees are required. One should be from your present or last employer if possible. School leavers should give your Headteacher. If you have not been in employment in recent years, you are welcome to give a suitable alternative referee of your choice.
1. / Name:
Occupation:
Address:
Telephone No. (inc. STD code):
2. / Name:
Occupation:
Address:
Telephone No. (inc. STD code):

DATA PROTECTION ACT

Information from this application may be processed by computer for purposes registered by the City Council under the data protection legislation. Individuals have the right of access to computerised personal data concerning them.

Please state any particular assistance or facilities you may require in attending an interview.

REHABILITATION OF OFFENDERS

Because of the nature of work for which you are applying, this post is exempt from the Rehabilitation of Offenders Act 1974. You will be required to disclose, on a separate form (EDPOC), all information about any convictions in a Court of Law, no matter when they occurred, so that a Police check can be carried out if you are offered an appointment. If you are subsequently employed by the Authority, and it is found out that you failed to disclose any previous convictions, this could result in dismissal, or disciplinary action by the Authority. All information will be treated in confidence, and will only be considered in relation to an application for posts to which the exemption order applies.

Have you been cautioned or convicted of any criminal offence? /

NO

/

YES

If yes, please give details:
Are you related to, or the partner of, a governor or employee of the School or Plymouth City Council? /

NO

/

YES

If yes, please state name, post and relationship:

SIGNATURE

I declare that all statements, made by me in my application for this post, are true to the best of my knowledge.

Signed: / Date:

NBThis form must be returned to the Manager at the address specified in the advertisement.

LETTER OF APPLICATION

Name in Full:
Post:

Please write in support of your application, showing how your experience and qualifications are relevant to this post.

Please give details of any other relevant professional development or training undertaken in the last five years. Could you also include your involvement or willingness to be involved in extra-curricular activities, as well as any personal interests that may be relevant to this post.

Please complete in black as this application may be photocopied.

SCHOOLS MONITORING FORM: PRIVATE & CONFIDENTIAL APPLICATION NO: …………….

THIS INFORMATION IS FOR MONITORING PURPOSES ONLY AND WILL NOT BE CONSIDERED AS PART OF THE SELECTION PROCESS.

Plymouth City Council believes in equal opportunities. Part of this involves ensuring that our recruitment and selection practices are fair, equitable and consistent, with the aim of appointing the best person for the job and fulfilling statutory duties relevant to equality in employment. Further information is contained in this form under “Our Promise to You”.

To make equal opportunities meaningful, it is essential that the Council monitors the effectiveness of its policy. Please therefore complete this form. All information will be treated in the strictest confidence, and will not be made available to the selection panel. Please, therefore, complete the following:-

  1. Job applied for: ………………………………………………………………………………………..
  1. School/College: ………………………………………………………………………………………..
  1. Grade: ………………………………………………………………………………………………….
  1. Closing date: …………………………………………………………………………………………..
  1. Where did you find out about this vacancy? ……………………………………………………….

6.What is your sex?FemaleMale 

  1. What is your age: ……………………………………………………………………………………..

8. Do you need permission to work in the UK?  Yes  No

9. Are you able to produce documents if asked for at interview which demonstrate that

you are entitled to work in the UK?  Yes  Yes

10. If this post is open to job share, do you want to be considered for this option?  Yes  No 11. How would you best describe your Ethnic origin? Please tick.

  1. Bangladeshi ……………………………………………………………………….
  2. Black-African ………………………………………………………………………
  3. Black-Caribbean ………………………………………………………………….
  4. Black – Other (Please specify) ………………………………………………….
  5. Chinese …………………………………………………………………………… 
  6. Indian ……………………………………………………………………………...
  7. Pakistani …………………………………………………………………………..
  8. White-European (including UK) …………………………………………………
  9. Other (please specify) ……………………………………………………………

12.a)Do you consider yourself to be a disabled person? NO  YES 

b)If you answered Yes to a), please tick box(es) applicable:

i) Mobility impairment …………………………….

ii)Hearing impairment …………………………….

iii)Sight impairment ………………………………..

iv)Learning difficulties ……………………………..

v)Other (Please state)……………..………………

PREVIOUS EMPLOYMENT (Most recent appointment first)

Continuation Sheet

5. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
6. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
7. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
8. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:

PREVIOUS EMPLOYMENT (Most recent appointment first)

Continuation Sheet

9. / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
10 / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
11 / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year:
12 / Post Title: /

F/T:

/

P/T:

Employer: / Salary/Wage: / £
Address:
Postcode:
Brief description of duties and responsibilities:
Reason for leaving:
Date From: / Month: / Year: / Date To: / Month: / Year: