APPLICATION FORM

Please return to or Human Resources, University of Abertay Dundee DD1 1HG

CVs may be attached, however please fully complete this application form

For the post of: / Reference:
Surname / Initials
Permanent Address / Telephone: Daytime:
Evening:
Mobile:
E-mail:
Please indicate if any of the above details are not suitable for contact
(i.e. current place of employment)
Name and address of current/most recent employer / Date(s) of employment (Month/Year)
Full/Part Time
Job title and key areas of responsibility in current or most recent role
Notice Required / Current Salary
Further and higher education qualifications – Include secondary education if you left school less than five years ago or have no further education qualifications.
Institution / Course/examination title / Results
Current Membership of professional bodies
Awarding body / Class of membership
Employment History (most recent post first, exclusive of data provided on front page)
Employer’s name and address / Job title and key areas of responsibility / F/T or
P/T / From To
(month/year)
References
Please supply the name, address and position of three referees. We will normally approach Referees prior to interview unless you signify otherwise. We require at least one reference from your current/most recent employer.
Name and position / Contact Address / Relationship (i.e. Manager, Tutor etc) / OK to contact
prior to interview?
1
2
3
Additional Information in support of your application, including research & consultancy with dates of publications where appropriate. (Use extra space/page if needed or refer to CV if attached)
National Insurance Number
Do you require a work permit?
Have you been a member of a local government pension before?
  • If you are selected for the post we will ask you to complete a medical questionnaire, which will only be viewed by the Occupational Health Adviser.
  • If you have not heard from us within 6 weeks of the closing date please assume that your application has been unsuccessful.

I certify that, to the best of my knowledge, the information given on this application is accurate and without omission.
Signature / Date

Equal Opportunities Monitoring

This information will be separated from your application in the Human Resources Department as soon as we receive it and used solely for the purpose of equal opportunities monitoring.

The University Of Abertay Dundee is committed to being an equal opportunities employer. Ongoing monitoring and regular analysis of the data supplied on this form indicate the key characteristics relating to equal opportunities and provide the basis for continual improvement in this area. Please note that the categories/codes identified have been pre-determined by the Higher Education Statistical Agency.

Full Name / Post Title & Reference Number
Date of Birth / GenderMale/FemalePlease circle
Ethnic Origin
How would you describe your ethnic origin? Please tick which of the following categories best describes you.
White - British / White - Irish
White - Scottish / Other White Background
Black or Black British - Caribbean / Black or Black British - African
Other Black Background / Asian or Asian British - Indian
Asian or Asian British - Pakistani / Asian or Asian British - Bangladeshi
Chinese / Other Asian Background
Mixed - White and Black Caribbean / Mixed - White and Black African
Mixed - White and Asian / Other Mixed Background
Other Ethnic Background – Please State / Information Refused
Disability
Please note: the Disability Discrimination Act defines a disability as any physical or mental impairment which has, or would have (if the person was not receiving treatment), a substantial and long term (i.e. more than 12 months) adverse effect on a person’s ability to carry out normal activities. You may still be considered to be disabled under the terms of the Act if you are not currently adversely affected, but it is deemed that the impairment is likely to recur. This definition can include diabetes, depression, blindness, etc. and is much broader than previous definitions.
Please tick which of the following categories best describes you.
Not know to be disabled / Declared disabled
Please tick which of the following categories best describes your disability:
(If you are short listed, we will ask you about any special requirements before interview – please do not put these details on the application form).
Hearing / Learning difficulty (e.g. Dyslexia)
Mental health difficulty / Mobility
Visual (not corrected spectacles or contact lenses) / Other – Please State
Where did you see this job advertised?
Signature / Date

Criminal Record Information for Posts Exempt From The Rehabilitation of Offenders Act 1974 (Disclosure Scotland Clearance Required)

The University of Abertay Dundee aims to promote equality of opportunity for all with the right mix of talent, skills and potential. We welcome applications from diverse candidates. Criminal records will be taken into account for recruitment purposes only when the conviction is relevant. The job you have applied for is exempt from the Rehabilitation of Offenders Act 1974 and we require information about both ‘spent and unspent’ convictions. Having a ‘spent or unspent’ conviction will not necessarily bar you from employment. This will depend on the circumstances and background to your offence(s).

Full Name / Post / Reference Number

If you need more information, please contact the University HR Adviser in confidence.

Declaration
Do you have any convictions, spent or unspent? Yes No
If yes, please provide details of dates, courts, details of offence(s) and sentence(s).
Signature / Date

University Of Abertay DundeeHRR&S 06

Recruitment & Selection Policy – Application Form Revision A

Page 1 of 6June 2002