Post applied for

Instructions/guidance for completing this application form

·  Read all the material provided in the information pack that has been sent to you. This will give you the opportunity to assess whether the post is suitable for you.

·  You may wish to write your application out in draft, as this will prevent unnecessary mistakes.

Consider all the points you wish to make in support of your application.

§  Make sure that your application is geared around the job you are applying for.

§  Give as much detail as you can about your present or last post. This will show

the skills you are currently using and may uncover areas you may not think are

important.

§  Remember to include previous employment if the duties/responsibilities in

those jobs are relevant to this post.

§  Please do not stick pages onto the form, but include additional separate pages

as necessary.

Inclusion of CVs

Details of present or most recent employment.

(Please also give details of any other employment which, with the job applied for, would

mean you would be working more than an average of 48 hours per week).

Please outline the main duties/responsibilities of this job:

Section 2 –

Period of course.
Indicate whether full or part time. / Name of College or University attended / Degree or certificate obtained. (If degree state Hons., Class or Pass) / Date of award / Subjects (main and subsidiary where appropriate)
Dates / School/College/University / Details of course/subjects
covered / Qualifications obtained.
Include grades for A levels or equivalent qualifications
Dates / Course organisers / Course length / Brief details of course

Do you hold a valid First Aid Certificate? Yes No Expiry date

Please give dates when you are not available for interview.

References

Please give the names and addresses of two people to whom we may write for references.

Referee 1 should be your present or most recent employer. Please state whether Referee 2 is

in a personal or employment capacity.

Referee 1 (Present or most recent employer) Referee 2 *Employment/Personal capacity (*delete)

(This referee should not be a relative)

Name Name

Job title Job title

Address Address

Tel number Tel number

Email Email

If you are shortlisted for this post, may your referees be contacted prior to interview?

Yes No Yes No

If you are selected for interview you will be asked to bring proof of your professional

qualifications and any other relevant certificates.

Thomas Rotherham College

Equality and Diversity Monitoring Form

Personal details (all information will be treated in confidence)

It is the aim of our equal opportunities policy to ensure that all prospective employees are treated solely on the grounds of merit, irrespective of age, disability, ethnic origin, gender, marital status, religion, sexual orientation or nationality. We are committed to the monitoring of this policy.

Information on this form will be held separately from the application form and will not be used during the shortlisting and interview process.

Post applied for

Post applied for

Job ref No.

Job Code

Surname

Forenames

Job ref

Title

Address Tel

Date of birth

Date of birth My age is: 16-17 18-24 25-35 36-45 46-55 over 55

My gender is: Male Female My National Insurance Number is

My driving licence status is: Full Temporary Do not have a driving licence

(If it is an essential requirement for you to hold a clean full driving licence this will be included on the personal specification for the post and mentioned in the job description).

Do you have a disability as defined in The Disability Discrimination Act? Yes No

Under the terms of the Disability Discrimination Act 1995, a person has a disability

if s(he) has a physical or mental impairment which has a substantial long-term adverse

effect on his/her ability to carry out normal day to day activities.

Yes No If you do have a disability, are there any specific arrangements which the College

can make for you if you are called for interview, in terms of:

o  Physical arrangements that are made for the interview – e.g. car parking?

o  Conduct of the interview – e.g. interpreter services?

o  Completion of selection tests, if used?

Yes No If yes, please supply details of your requirements

Ethnic Origin

Ethnic Origin

Ethnic origin questions are not about nationality, place of birth or citizenship. They are about colour and broad ethnic group. This information is used for monitoring purposes only.

I would describe my ethnic origin as:

Asian or Asian British Black or Black British Other Ethnic Groups

Indian Caribbean Chinese

Pakistani African Any other ethnic group

0  Bangladeshi Any other black background Not known/not provided

1  Any other Asian background

Mixed White

White and Black Caribbean British

White and Black African Irish

White and Asian Other

Any other mixed background

Criminal Records Bureau Disclosure

Posts that involve direct contact with students will require the successful applicant to complete a CRB disclosure check.

Criminal convictions

Have you ever been convicted, cautioned or bound over, or are you waiting to hear about a conviction which is not considered spent?

Yes No

Immigration regulations

In order to comply with current immigration regulations, will you require a work permit before taking up this employment?

Yes No

Are you related to any Governor or Senior Manager at the College?

Yes No If yes, please give details.

Health

Applicants will be required to demonstrate an appropriate level of fitness for the duties of the post before an offer of employment is confirmed. This will include the completion of a Staff Disclosure Form and may include a medical examination by the College’s nominated GP. Further details will be given at the interview.

Where did you see this vacancy advertised?

General enquiry Job Centre Internal advertisement Newspaper advert TRC Intranet Other internet site (name)

Other Publication/Journal (name)

Other

Declaration

I confirm that the information contained in this application form is complete and correct. I understand that any false information given may make the offer of employment invalid or may lead to disciplinary proceedings which may result in disciplinary action including dismissal.

Signed Date