Particulars of Position Applied For

An equal opportunities employer

MORDEN COLLEGE

19 St Germans Place Blackheath London SE3 0PW

Telephone: 020 8463 8330

PARTICULARS OF POSITION APPLIED FOR
Job Applied for:
Vacancy Reference: / Applicant Number:
(office use only)
How did you hear about the post? (please specify whether word of mouth, advertisement (name of paper), agency, online, other:word of mouthadvertisementagencyonline
PERSONAL DETAILS
Surname:Title: Mr/Mrs/Ms/Miss/OtherMrMrsMissMs
Forenames:Previous or Former Names:
Home Address:
Post Code:
Telephone Home: / Work: / Mobile:
Only supply a telephone number if you are happy for us to use it, which will be done with discretion
Email Address:
National Insurance No:
GENERAL INFORMATION
Are you legally eligible to work in the UK?YesNo
If you are not a UK or European Union national, please state your work permit number or other document which will prove your entitlement to work in the UK
Have you ever been dismissed or asked to leave a job?YesNoIf yes, please give details
Have you ever previously worked for Morden College?
YesFromToNo
Are you a relativeor friend of any member of staff or resident of Morden College?
YesNoIf yes, please give details
Do you require any assistance to enable you to attend the interview?
YesNoIf yes, please give details
Do you require any reasonable adjustments to participate in the assessment process?
YesNoIf yes, please give details
Are you capable of doing the intrinsic functions that are required for this post?
YesNoIf no, please give details
REHABILITATION OF OFFENDERS ACT 1974 (Exceptions Order 1975)
The post for which you have applied is exempt from provisions of section 4.2 of the Rehabilitation of Offenders Act 1974, and accordingly you are not entitled to withhold information about convictions or imprisonment which, for other purposes, are "spent" under the provisions of the Act. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service Website ( Your answer to the following question must include any and all "spent" convictions. Any information given will be kept in strict confidence.
Have you ever received any Police warnings, reprimands, cautions or been convicted for any offence, including offences against the Road Traffic Act(s)? Yes No
Are you currently under investigation by the police for any reason?YesNo
If you have answered yes to either of the questions above, please give details in the box below regarding the offence and date. This will not necessarily debar you from employment.
DISCLOSURE AND BARRING SERVICE ENHANCED DISCLOSURE
In order to comply with the Care Standards Act we may require successful applicants to undertake a Disclosure and Barring Service (DBS) check at Enhanced or Standard level, depending on the post. Please note that a criminal record will not necessarily preclude you from employment at Morden College. Any information disclosed will be subject to a risk assessment and will only be a bar to employment where there is a potential risk to Morden College or the vulnerable adults in its care. Your DBS Disclosure will be reviewed periodically thereafter, as per Morden College policy.
As part of the criminal records check, the DBS Adult First barred list may also be checked. In relation to this list please sign the following statement:
“I have not been involved in any incident(s) of misconduct in relation to vulnerable adults.”
Signed: Date:
Please note: it is in your interests to ensure that all cautions, convictions, warnings, reprimands are declared.

This section of the application form will be removed before shortlisting.

PARTICULARS OF POSITION APPLIED FOR
Job Applied for: / Applicant Number:
(office use only)

This form may be photocopied. If completing by hand, please use a black pen.

Additional sheets (either written or typed) may be used if there is not enough space.

EMPLOYMENT HISTORY

Please provide details of your employment history, most recent first. Please ensure you explain any gaps in your employment history and include details of any voluntary or educational experience relevant to the post applied for. Please use an additional sheet if necessary.

Name & Address of Present/Most Recent Employer / Job Title:
Dates From: To:
Hours worked per week:
Current or Final Salary: £
Benefits:
Telephone No: / Reason for leaving:
Notice Period:
Please summarise your main duties and responsibilities in your current/last role (continue on a separate sheet if necessary and ensure it is named and attached to this form).
Previous Employer: Company name and address: / Dates From: To:
Final Salary: £
Job Title and main duties/responsibilities: / Reason for Leaving:
Previous Employer: Company nameand address: / Dates From: To:
Final Salary: £
Job Title and main duties/responsibilities: / Reason for Leaving:
Previous Employer: Company name and address: / Dates From: To:
Final Salary: £
Job Title and main duties/responsibilities: / Reason for Leaving:
Previous Employer:Company name and address: / Dates From: To:
Final Salary: £
Job Title and main duties/Responsibilities: / Reason for Leaving:
Previous Employer: Company name and address: / Dates From: To:
Final Salary: £
Reason for Leaving:
EDUCATION/QUALIFICATIONS
Qualification / Dates Attended / Institution / Awarding Body
MEMBERSHIP OF PROFESSIONAL ORGANISATIONS/INSTITUTIONS
Professional Body / Registration no/pin no: / Level Attained / Date of Expiry
OTHER TRAINING
Name of Course / Qualification(s) / Date / Training Provider and Location
For example: First Aid Course / Pass / St John’s Ambulance, Maidstone
SUPPORTING STATEMENT

Please use the space below to highlight details and experience which directly relate to the Person Specification for the role to which you are applying (use a continuation sheet if necessary).

REFERENCES

You must provide at least two references, one of whom should be your current employer. If you have not been employed before or you can only provide one business referee, please provide details of a contact at either your School or College and/or details of a private referee. If you have any queries, or are unable to provide two work related references, please contact the HR Department on 020 8463 8363.

We will not contact your present employer without your permission.

Reference 1 - Professional current / most recent employer
Name: (Mr/Mrs/Ms/Miss)MrMrsMissMs
Company:Position:
Address:
Post Code:
Email:
Telephone Number:
Relationship:Position Held:
Reference 2 – Professional previous employer
Name: (Mr/Mrs/Ms/Miss) MrMrsMissMs
Company: Position:
Address:
Post Code:
Email:
Telephone Number:
Relationship: Position Held:

May the referees given above be asked for a reference if you are offered an interview?

Referee 1YesNo

Referee 2YesNo

DECLARATION
I confirm that the above information given here is complete and correct and that any untrue or misleading information or serious omission will give Morden College the right to reject my application, to withdraw any employment contract offered, or if employed, to dismiss without notice.
Iunderstand that permanent appointments will be subject to health clearance from MordenCollege’s occupational health advisors.
I understand that all appointments will be subject to references which are satisfactory to Morden College.
I understand that the post, for which I am applying, is exempt from the Rehabilitation of Offenders Act 1974, and I will be required to consent to disclosure of confidential information from the Disclosure and Barring Service, which will be sent to me and Morden College.
I understand that the information I have provided in this form will be processed in accordance with the Data Protection Act and by signing this form I consent to my data being processed. If I am subsequently employed by Morden College, I understand this data will form the basis of my employment record; otherwise it can be destroyed 6 months after the vacancy is filled, unless a dispute arises when it will be retained for longer.
Signed:Date:

Please return your completed application form to:

Human Resources Department, Morden College, 19 St Germans Place, Blackheath, London, SE3 0PW.

Email:

EQUAL OPPORTUNITIES MONITORING FORM

Morden College operates an Equal Opportunities Policy and wants to ensure that all employees are treated according to their ability, the requirements of the job and in accordance with the values of the organisation. We are committed to ensuring that unfair and unlawful discrimination is eliminated. To assist us in monitoring the effectiveness of this policy, you are asked to complete the following questions. This information will be treated confidentially. This form will be detached from your application upon receipt and will not be used as part of the selection process.A disability or health problem does not preclude full consideration for the job and applications from suitable people with disabilities are welcome.

PARTICULARS OF POSITION APPLIED FOR
Job Applied for: / Applicant Number:
(office use only)

1I fall into the following age groups

Up to 18 18 – 24 25 – 34 35 – 44

45 – 54 55 – 64 65 – 74 Over 75

2What is your ethnic group? Tick one box from sections A to F

A – Asian or Asian BritishB – Black, African, Caribbean or black British

Bangladeshi African

Chinese Caribbean

Indian Any other black background (specify if you wish)

Pakistani

Any other Asian Background (specify if you wish)

C – Mixed or Multiple Ethnic GroupsD – White

White and Asian English, Welsh, Scottish, Northern Irish or British

White and black African Irish

White and Chinese Gypsy or Irish Traveller

Any other mixed background (specify if you wish)Any other white background (specify if you wish)

E – Any other ethnic groupF – Non disclosure

Arab I prefer not to say

Any other group (specify if you wish)

3What is your gender?

Male Female I prefer not to say

4Do you have a long-term impairment or disability?

Yes No I prefer not to say

Disabled applicants short-listed for interview will be contacted to discuss any support neededduring the selection programme and employment.