Application for Employment – Part 1

Please complete this form clearly and fully in black ink or typescript. Your application will be shortlisted based on the information you provide here.

Please send your completed application to Human Resources email or post to Marine Conservation Society, Over Ross House, Ross Park, Ross-on-Wye, Herefordshire HR9 7QQ

Please submit this form in an editable format (no PDFs) so Parts 1 & 2 can be separated.

When sending your electronic application, please save and submit with the following file name:

‘APPLICATION: JOB TITLE - YOUR NAME’

Application for the Post of:
In which publication or website did you see this role advertised?
Personal Details
Title:
Forename(s):
Surname:
Known as (if different from above):
Address:
Postcode:
Daytime telephone number:
Mobile telephone number:
Email address:
Are you related in any way to an employee or Trustee of MCS? / YES/NO If yes, please state the name and relationship:
This information is gathered to ensure that, as appropriate, the individuals involved are protected from allegations such as impropriety, bias, or conflict of interest whether during the selection process, or on any subsequent appointment.
References
Please provide details of two referees (including your current or most recent employer) who can provide relevant comment on your work performance. If you have just completed full-time education, an academic referee may be provided. If you have neither worked nor studied recently, please provide two character referees outside your family and friends, and not MCS employees.
Referee 1 – Current or most recent employer
Title & Name:
Position:
Business address:
Email address:
Telephone no.:
Relationship to you:
Can we contact this referee without further reference to you?
Referee 2 – previous employer
Title & Name:
Position:
Business address:
Email address:
Telephone no.:
Relationship to you:
Can we contact this referee without further reference to you?
Additional Information
Are you eligible to work in the UK?
Do you require a work permit to take up employment in the UK?
If you currently have a visa in order to work in the UK, are there conditions attached – e.g. start or finish dates? / YES/NO
YES/NO
YES/NO
Applications from ex-offenders are welcomed and will be considered on merit. Convictions that are irrelevant to this job will not be taken in to account. You are required to disclose any convictions, which are not 'spent' by virtue of the Rehabilitation of Offenders Act 1974.
Do you have any unspent convictions, or do you have any criminal charges pending? / State Yes or No.
If yes, this will be discussed in confidence with you by an HR Advisor.
Declaration
The information provided by me in this application is accurate and true. I understand that providing misleading or false information may disqualify me from appointment or may result in my dismissal.
I consent to the processing by means of a computer database or otherwise any information I provide MCS for the purpose of employment, in accordance with Data Protection Act 1998.
Applicant’s signature:
Date:

Diversity Monitoring Form - CONFIDENTIAL

MCS welcomes applications from people in every part of the community. We are committed to promoting a diverse workforce and to active policies which eliminate unfair discrimination. We aim to be an equal opportunities employer, and our policy is that job applicants and employees receive equal treatment regardless of ethnicity, religion or belief, age, disability, gender or gender identity, sexual orientation, marital status, maternity/paternity status, where any of these cannot be shown to be a requirement of the job concerned.

Recruitment, selection and promotion procedures will be monitored to ensure that individuals are selected, promoted and treated on the basis of their relevant merits and abilities. To assist us in monitoring the operation of our equal opportunities policy, and for no other reason, please answer the questions below. Your responses will provide statistical information which we can use in order to ensure our policies are being properly implemented and that our services are accessible to all.

Your responses will be treated and held in strict confidence and will not be used to identify you.

The information you provide will not affect your application, and your responses will not be known by the short-listing or selection panel. This form will be separated from your application.

Data Protection Act 1998

The data collected in this form will only be used for the purpose of statistical monitoring.

This information will only be retained for as long as is considered necessary for monitoring purposes and then it will be securely destroyed. At all times it will be kept in accordance with this Act.

We thank you for your co-operation in completing this form.

Your name (used only to track your progress through the selection process for equality and diversity monitoring purposes):
Post applied for:
Gender (please cross one box only):
Male  / Female  / Prefer not to say 
Date of birth:
Age (please cross one box only):
Under 25 / 25 – 34 / 35 – 44 / 45 – 54 / 55 – 64 / 65+
 /  /  /  /  / 
Sexuality
Which term would best describe your sexuality? (Please cross one box only)
Lesbian / Gay / Bi-sexual / Heterosexual / Prefer not to say
 /  /  /  / 
Disability
The Equality Act 2010 defines disability as: “A physical or mental impairment which has a substantial and long term adverse effect on the ability to carry out normal day-to-day activities.” Long term means that its effect is usually lasting, or likely to last, 12 months or more.
Do you consider yourself to have a disability (please cross one box only):
Yes  / No  / Prefer not to say 
If yes, please indicate the nature of the disability (please cross all boxes that apply):
Visual impairment /  / Physical impairment / 
Hearing impairment /  / Learning disability or difficulty / 
Mental health condition /  / Chronic long-term illness (e.g. MS, cancer) / 
Other (please specify / 
Do you have any special provisions that we need to be aware of at the interview stage? / YES/NO
If yes, please state:
Cultural and ethnic origin (please cross one box only):
White – British /  / Asian or Asian British – Bangladeshi / 
White – English /  / Asian or Asian British – Indian / 
White – Irish /  / Asian or Asian British – Pakistani / 
White – Scottish /  / Asian or Asian British – other / 
White – Welsh / 
White – other European /  / Black or Black British – Caribbean / 
White – other /  / Black or Black British – African / 
Black or Black British – Other / 
Mixed – White and Asian / 
Mixed – White and Black African /  / Chinese / 
Mixed – White and Black Caribbean / 
Other (please specify) / 
Prefer not to say / 
Religion or belief (please cross one box only):
Atheist /  / Jewish / 
Buddhist /  / Muslim / 
Christian /  / Sikh / 
Hindu /  / Other (please specify) / 
Prefer not to say / 

Application for Employment – Part 2Ref:(HR TO COMPLETE)

Information from this section onwards is provided to the recruiting manager – they do not see Part 1 of this document including the Diversity Monitoring form. Please submit this form in an editable format (no PDFs) so that Parts 1 & 2 can be separated.

All boxes are expandable, or continue on a separate sheet if necessary.

Current or most recent employment
Position held:
Name, address, telephone number of employer, and nature of business:
Dates employed (from – to):
Current salary, and any benefits:
Notice required:
Reason for leaving, or intending to leave:
Brief description of duties/responsibilities and key achievements:
Previous employment
Positions should be listed in date order, with the most recent first. Include any part-time or holiday jobs, or voluntary roles.
You should account for any gaps in your employment history (subject to the provisions relating to disclosure under the Rehabilitation of Offenders Act 1974).
Please note previous employers may be approached by MCS to verify employment history.
Name and address of employer, and nature of business:
Position held:
Dates employed (from – to):
Salary:
Reason for leaving:
Briefly describe/list primary duties and key achievements:
Name and address of employer, and nature of business:
Position held:
Dates employed (from – to):
Salary:
Reason for leaving:
Briefly describe/list primary duties and key achievements:
Name and address of employer, and nature of business:
Position held:
Dates employed (from – to):
Salary:
Reason for leaving:
Briefly describe/list primary duties and key achievements:

Copy these boxes to continue your employment history if necessary

Qualifications
Please tell us about your education and any qualifications which you feel are relevant to the post. Include any relevant courses which you are currently undertaking. Please start with the most recent first. Add extra lines as required.
Place of study / Qualification / Grade / Date achieved
Professional training courses
Please detail here any professional development you have undertaken which is relevant to the post you are applying for. Please start with the most recent first.
Training attended / Training provider / Duration / Date
Professional Memberships
Name of Professional Body / Type of Membership / Membership Number
Supporting Statement on skills, knowledge and experience.
Tell us how you’re the right candidate for this role.
IMPORTANT:Your statement will be assessed for short-listing in relation to the job description and person specification, so please refer closely to both when completing this section. Your statement should include examples of your work or experience to evidence how you meet the job criteria and person specification and what skills you bring which would make you successful in the role..
Continue on a separate sheet, but please do not exceed more than two additional sides of A4.