Please Complete This Form in Black Ink Or Electronically
Instructions
- Please complete this form in black ink or electronically.
- Make sure to read the questions carefully
- In addition to this application form you must also provide
- a Curriculum Vitae (CV) – this must be no longer than two sides of A4
- a letter of support from your PhD supervisors
Internship position applied for
Economic and Social Research Council (ESRC) Doctoral Training Centre (DTC) for Wales and NSPCC Cymru/Wales Internship
Internship title
Exploring well-being indicators and examining how they can be used to safeguard and protect children from abuse and neglect.
Personal details
Title (e.g. Mr, Ms, etc.)
Forename(s)
Surname
Address
Postcode:
DTC Pathway & Institution
Daytime phone number
Evening phone number
Can we mention NSPCC/Childline if we contact you at work? (please tick the appropriate box) / Yes / No
Why do you want to have an internship with us? (maximum of 300 words)
Supporting statement (500 words)
Please use this section to tell us why you feel you would be suitable for this role. Specifically we’d like you to think about the following:
- Details of your current research interests and previous experience.
- Information on your interests, background and skills that you feel would make you a suitable candidate for this role.
- What you feel it would mean for your own career development?
References
Please give the names and addresses of two people, not relatives, who would be willing to provide references covering at least the last five years. The references can either be personal or work-based but both referees should be able to comment on your suitability for this volunteering role.
Reference One / Reference Two
Name / Name
Address / Postcode: / Address / Postcode:
Telephone / Telephone
Email / Email
How long have you known this person? / How long have you known this person?
Interview arrangements
Interviews are likely to take place in in last 2 weeks of November 2015. Please tell note any weekdays in that period when you couldn’t attend.
Please tell us of any particular needs you have, which we should be aware of when inviting you for interview (e.g. wheelchair access)
Criminal convictions
Please disclose any criminal convictions not spent under the Rehabilitation of Offenders Act 1974? / Yes / No
If yes please provided details
Storing your information
If I am offered an internship by the NSPCC/Childine, I agree that all of the information on this form may be retained and some will be held on a computer database. If I am not successful, I understand that all recruitment information will be destroyed shortly after the completion of the recruitment process.
Declaration
I confirm the following:
- That the information I have given is correct and complete, and that any false statements of omissions may mean my services will be terminated.
- I agree to my information being stores as advised above.
- I understand that the NSPCC will not at any point employ me, or have any employer liability, towards me for this internship.
- I am aware that if successful I will have to sign a confidentiality policy with the NSPCC
- I understand that any unspent criminal offences must be disclosed and that failure to do so may mean my services will be terminated.
- I understand that if successful any works created in the course of the internship will be the property of the NSPCC. In return for the NSPCC providing you with the opportunity to complete an Internship, you assign to the NSPCC all existing and future intellectual property rights (including, without limitations, patents, copyright and related rights) and invention arising from these works. You also agree to irrevocably waive all moral rights under the Copyright, Designs and Patents Act 1988 (and similar rights in other jurisdictions) which you would, or will, have on any existing or future works.
Signed
Printed name
Date
Please return this form to:
The Manager, Wales ESRC Doctoral Training Centre, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ or