Before Completing Please Refer to the Application Notes Section on Page 9

Application for Employment

PLEASE COMPLETE ALL SECTIONS OF THIS APPLICATION FORM AS WELL AS THE ATTACHED CRIMINAL CONVICTIONS DECLARATION FORM WHICH MUST BE SUBMITTED WITH YOUR APPLICATION FOR EMPLOYMENT WITH LEARNING PARTNERSHIP WEST.

This application form has been created using tables. We recommend that you use overtype mode rather than insert mode to help preserve box sizes and page breaks (press your Insert key to switch between modes). Alternatively you can print the form and complete it clearly in black ink.

Before completing please refer to the Application Notes section on Page 9.

Please return completed applications to the following address: 4 Colston Avenue, Bristol, BS1 4ST

Or e-mail to:

SECTION 1.
TITLE OF THE POST(S) YOU ARE APPLYING FOR: / POST REF / (for Learning Partnership West completion)
Closing Date / Applic Ref / Date Received
1.
2.
3.
Where did you see the position(s) advertised?
SECTION 2. YOUR PERSONAL DETAILS
Surname: / Other Names:
Title: / Known As
Your Address:
Post Code:
Daytime Phone Number: / Evening Phone Number:
Mobile Number: / E-mail address:
May we contact you at work?
YES/NO* * Delete as appropriate
SECTION 3. PRESENT OR MOST RECENT EMPLOYMENT
Name and Address of Employer / Title of Post Held / Brief description of duties and responsibilities
Period of appointment
(DD/MM/YY) / From: / To:
Grade and/or Salary: / Full-time or Part time:
Period of Notice required if applicable:
Reason for leaving if applicable:

SECTION 4. PREVIOUS EMPLOYMENT HISTORY

Beginning with the most recent. (If necessary continue on a separate sheet, which includes your name)
Employer Name
and Address / From / To / Brief Outline of the
Role and Responsibility / Reason for leaving
Please give details and an explanation of any gaps in your employment history. Any dismissal or redundancy must be clearly stated. Please indicate if any previous employer or voluntary group has closed down. Continue on a separate sheet if necessary.

SECTION 5. QUALIFICATIONS OBTAINED OR CURRENTLY BEING UNDERTAKEN

Please show subjects studied & results obtained. List qualifications from most recent to secondary education. (If necessary continue on a separate sheet, which includes your name).
Subject/Course Title / Dates / Result / Course Centre or education establishment

SECTION 6. MEMBERSHIP OF PROFESSIONAL BODIES

Include in this section any relevant professional memberships

Professional Body

/

Membership or Registration Type

/

Membership Number

/

Expiry/Renewal Date

Please complete the post reference and your name in the above section. If you are applying for more than one post with different job descriptions or focus sheets, please complete a separate Additional Information section for each post.

SECTION 7. ADDITIONAL INFORMATION
POST REF: / NAME: / For Learning Partnership West completion
App Ref:
Include any additional information in this section which you feel will support your application. This may include why you are applying for the post and why you think you are suitable for the position. You may wish to include details of any relevant voluntary work or experience outside of your formal employment. Please do not add or refer to CVs in this section. Continue overleaf if necessary. A maximum of two sides may be submitted for each post.
SECTION 7. ADDITIONAL INFORMATION (continued from previous page)
SECTION 8. KNOWLEDGE & EXPERIENCE OF COMPUTER TECHNOLOGY
All Learning Partnership West staff are required to use computerised systems in their work. Please indicate the level of your experience and systems /software you are familiar with.

SECTION 9. REFERENCES

Please give the full name, address and telephone number of two referees, one of which must be your present or most recent employer. (Please note that all offers of employment are subject to satisfactory references.) If you are a student please provide contact details of a teacher at your school, college or university. Please note that personal references such as friends and relatives are not acceptable. For all posts, written references obtained must cover the preceding 3 years of employment.
1. Current/most recent employer / 2. Second referee
Name:
Position:
Company Name:
Address:
Telephone No:
E-mail address:
Can we contact this referee before an offer of employment is made? / YES / NO*
*Delete as appropriate / YES / NO*
*Delete as appropriate
Additional referee details where current and second referee does not cover preceding three years employment:
3. Third referee / 4. Fourth Referee
Name:
Position:
Company Name:
Address:
Telephone No:
E-mail address:
Can we contact this referee before an offer of employment is made? / YES / NO*
*Delete as appropriate / YES / NO*
*Delete as appropriate
SECTION 10. SUPPLEMENTARY INFORMATION
When are you available to start work?
Are you required to hold a work permit? /

YES/NO* *Delete as appropriate

What type of permit do you hold?
/

Please give details:

If YES, when does your current permit expire? /

Date:

If appointed to this post will you retain any other form of paid employment (If YES please give details) / YES / NO* *Delete as appropriate
Please give details (name & relationship) of any Board Member or employee of Learning Partnership West to whom you are related.

SECTION 11. DECLARATION

I acknowledge that all Learning Partnership West posts involve working with young people under the age of 18 and as such are not subject to the Rehabilitation of Offenders Act 1974. Employment is therefore subject to satisfactory Disclosure checks with the Criminal Records Bureau.
I declare that I am not disqualified from working with children and vulnerable adults (pursuant to the Protection of Children Act 1999, the Criminal Justice and Court Services Act 2000 and the Care Standards Act 2000).
NB. A criminal record will not necessarily bar you from employment with us. This will depend on the nature of the position and the circumstances and background of the offences.
I consent to the necessary enquiries and checks being undertaken by Learning Partnership West in order to confirm that the information included in this application is correct, to verify the authenticity of my qualifications and to ascertain whether I have a relevant criminal record which may make me unsuitable for the post applied for.
I declare that all the information I have provided is true. I further understand that providing false information, deliberate omissions or misrepresentations will disqualify me and if such failure, or false information, is discovered after appointment I may be liable for dismissal without notice. This applies equally to any medical questionnaire/forms I may complete.
Signed:...... Date:......
If you are sending this application form by e-mail then in the absence of this signature you should note that the e-mailing of this application constitutes your personal certification that the details in this application are correct. Shortlisted applicants will be required to sign their application form when attending for interview.
SECTION 12 - APPLICATION NOTES
Learning Partnership West is committed to equality of opportunity in all aspects of the organisation’s work. It is the policy of Learning Partnership West to select, appoint, employ and develop its employees on the basis of their suitability for the work to be performed. It is our intention that no applicant or employee receives less favourable treatment on the grounds of gender, race, ethnic origin, religion, marital status, disability, age, or sexual orientation, or is disadvantaged by conditions or requirements which cannot be shown to be justifiable”
Before completing this application please read the following notes:
1.  Please complete all sections of this application as fully as possible and in black ink if printing the form.
2.  If you run out of space in the relevant section continue on a separate sheet, which includes your name and indicating the attachment.
3.  Please do not attach and refer to your CV unless this is specifically requested.
4.  Please do not attach original copies of any personal documents to your application.
5.  Please ensure sufficient postage has been paid if sending your application by post as this may result in delays causing you to miss the closing date.
6.  References may be sought if you are short listed for interview. If you do not wish a reference to be taken up at this stage please indicate this in the appropriate section of the application.
7.  Confirmation of the appointment of successful candidates will be subject to:
·  Receipt of satisfactory references;
·  Confirmation of medical fitness for the duties of the post;
·  Proof of identity, qualifications and previous employments;
·  Satisfactory disclosure from a criminal record check (where appropriate to the post)
·  Satisfactory completion of a probationary period of employment;
·  Successful completion of any training requirements for the post.
8.  As part of our equal opportunities policy we monitor all applications for employment. To assist us in this process please complete the enclosed equal opportunities monitoring form and return it with your application. This will not be passed to the short-listing panel but will be used for statistical purposes.
9.  All applications for employment will be acknowledged. We will contact you again after the short-listing process. Applications that arrive after the closing date will not normally be considered.
10.  Please note that we only provide feedback, where requested, to candidates who are interviewed. We are unable to provide feedback to applicants who are not short-listed.

Equal Opportunities in Employment - Inclusion and Diversity

Learning Partnership West is committed to maintaining and promoting a culture of diversity and inclusion in which fairness and equality of opportunity are central to our employment practices and the achievement of our business objectives. We are working towards a workforce, which fairly represents all sections of the community. The information you provide below will be used to monitor our Equal Opportunities Policy and to ensure that it is working in practice. It will be treated in the strictest of confidence.
The information on this form is for monitoring purposes only and will not be made available to those assessing your application. The information provided will be treated in the strictest confidence and will not affect your job application in any way.
This information forms no part of the recruitment process. It will be detached from your application upon receipt.

Your Name:
Position you are applying for:
Your date of birth: /
Gender: MALE / FEMALE
Disability: Learning Partnership West wishes to ensure that employees and candidates for employment receive appropriate support and facilities in respect of disabilities and special needs in the workplace.
Do you consider yourself to have a disability YES / NO* *Delete as appropriate
The Disability Discrimination Act defines disability as "A physical or mental impairment which has a substantial and long-term effect on the person's ability to carry out normal day-to-day activities."
If you have answered YES above please detail any support measures or special arrangements required to enable you to attend for interview.
If appointed, do you need any specific support measures or equipment to enable you to carry out the duties required of the role?

Ethnic Origin

Please specify your ethnic group below. This information will not be supplied to the panel and will help us establish the broad ethnic groups of people responding to our job advertisements. (Categories in this section have been taken from the 2001 census).
A : White / D : Black or Black British
British / Caribbean
Irish / African
Any other White background (please specify) / Any other Black background (please specify)
B : Mixed / E : Chinese or other Ethnic Group
White & Black background
White & Black African
White & Asian / Chinese
Any other Mixed background (please specify) / Any other background (please specify)
C : Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background (please specify)

Religious Belief

Please specify your religious belief group below.
Prefer Not To Say / Hindu
Buddhist / Jewish
Christian / Muslim
None / Sikh
Other

Sexual Orientation

Please specify your sexual orientation below.
Prefer Not To Say / Gay
Lesbian / Bisexual
Heterosexual / Other (please state)