The PACE Centre

/ The Pace Centre
APPLICATION FORM
PRIVATE & CONFIDENTIAL

PLEASE COMPLETE USING BLACK INK OR TYPE

APPLICATION FOR THE POST OF:
SURNAME:
TITLE: MrMrsMissMsDr / FORENAME(S):
Please give details of any previous surnames:
ADDRESS FOR CORRESPONDENCE:
POSTCODE:
E-MAIL ADDRESS: / TELEPHONE NUMBERS
HOME:
WORK:
May we contact you at work? Yes/No
MOBILE:
NATIONAL INSURANCE NUMBER:

PRESENT OR MOST RECENT EMPLOYMENT

Name & address of employer:
Nature of business: / Job title and summary of main duties:
Are you stillcurrently employed by this organisation?YesNo
Date of appointment: / Salary Scale and Current Salary:
Reasons for leaving (If applicable): / Notice required:
PREVIOUS EMPLOYMENT
Please summarise your employment history since leaving full-time education, paid or unpaid, or working in a voluntary organisation or agency, full or part-time. Start with the most recent. Please continueona separate sheet if necessary.
Employer’s name and address / From
Month / Year / To
Month / Year / Job title and summary of main duties / Reasons for Leaving

Please describe the reason and duration of any period(s) longer than 1 month when you have not been in employment since leaving full-time education.

Qualifications and Training

EDUCATIONAL AND ACADEMIC QUALIFICATIONS (Secondary, Further/Higher or work based)
Please give details of your education with examination dates, results and qualifications obtained. Please include any training and membership of professional bodies, relevant to the application. (Please continue on a separate sheet if necessary) Evidence of qualifications may be requested.
School, College, University / Examination, course
(with dates) / From / To / Result/Qualifications gained
Applicants for Teaching Posts Only
Teacher Reference Number
Do you have Qualified Teacher Status?
QTS certificate number (where applicable)
Date of Qualification
Are you subject to a teacher prohibition order, or an interim prohibition order, issued by the secretary of state, as a result of misconduct?
Are you subject to a General Teaching Council sanction or restriction?

INSERVICE TRAININGGive details of the most recent, relevant courses attended and indicate any awards earned.

Course Title / Provider / Duration / Dates

References

Give details of two* people who have knowledge of you in a working / educational environment, paid or unpaid. The first reference should be your present or most recent employer. If you are a student give appropriate school or college referees. References must cover a consecutive five year period. It is the normal practice for references to be obtained before any formal interview. If you are currently working with children your current employer will be asked about disciplinary offences relating to children, including any for which the penalty is time expired and whether you have been the subject of any child protection concerns, and if so, the outcome of any enquiry or disciplinary procedure. If you are not currently working with children but have done so in the past, that previous employer will be asked about these issues.
*Applicants for Therapy, Teaching and Conductor positions should provide four referees. Other applicants should provide two referees.
If you were known to any of your referees by another name please give details:
1st Referee / If this is your current employer please confirm that we can contact before interview. Yes/No YesNo / 2nd Referee.
Name: / Name:
Position: / Position:
Address: / Address:
E-mail Address: / E-mail Address:
Tel: / Tel:

In what capacity does the above know you?

Third
Referee /

In what capacity does the above know you?

Fourth
Referee
Name: /
Name:
Position: / Position:
Address: / Address:
E-mail
Address: / E-mail
Address:
Tel: / Tel:

In what capacity does the above know you?

Achievements, Personal Qualities and Skills

Please use this section to say why you are applying for this job. Give details of any work or other experience you have which may be relevant to your application, including voluntary work and leisure interests. The information you provide about your experience, knowledge, skills and abilities enables us to assess whether you are the right person for the job. Make sure you read the job description and person specification before completing the application form and refer to it throughout. Provide as much information as possible, giving us examples, either from your home or work life, to show how you meet what we are looking for.
Please continue, if necessary, on a further sheet, which must be attached securely to this form.

Additional Information

To comply with the Asylum and Immigration legislation during the selection process you will be required to give evidence of your ability to work in the UK. Do you require any documentation supplied by the Home Office or UKBA in order to work in the UK?

/ Yes/No

Under the Working Time Directive, you should not work more than 48 hours a week. Do you plan to undertake work for other employers, which would cause a breach of these regulations?

/ Yes/No
If so, please give details:

Do you hold a full current driving licence?

/ Yes/No

Are you able to travel to different locations?
Would you work full time?
If part time, state days/hours

/ Yes/No Yes/No

Have you ever been subject to any disciplinary action by your employer or professional body?

/ Yes/No
If yes, please give details

Are you a relative or partner of an employee or Trustee of the PACE Centre?

/ Yes/No
If yes, please state name of person and relationship:

If you have a disability please let us know of any special arrangements you may need to make if you are short listed for interview:

Where did you see the advertisement for this post?

Disclosure and Barring and Childcare Disqualification

Paceis legally obligated to process a Disclosure and Barring Service (DBS) check before making appointments to relevant posts. The DBS check will reveal both spent and unspent convictions, cautions, and bind-overs as well as pending prosecutions, which aren’t “protected” under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975.
We’ll use the DBS check to ensure we comply with the Childcare Disqualification Regulations
Any data processed as part of the DBS check will be processed in accordance with data protection regulations and Pace’s privacy statement.
Do you have a DBS certificate?:☐Yes☐NoDate of check:
If you’ve lived or worked outside of the UK in the last 5 years, Pace may require additional information in order to comply with ‘safer recruitment’ requirements. If you answer ‘yes’ to the question below, we may contact you for additional information in due course.
Have you lived or worked outside of the UK in the last 5 years?: ☐Yes☐No

Declaration

I agree that any offer of employment with the PACE Centre is subject to satisfactory evidence of the right to work in the UK, satisfactory references and medical and police clearance (where appropriate). In accordance with the 1998 Data Protection Act and the General Data Protection Regulations the Pace Centre collects and processes personal data relating to job applicants as detailed in the job applicant privacy notice as detailed below.We are required by data protection law to give you the information in this privacy notice. It is important that you read the privacy notice carefully. Should your application be successful, when you start work for us, we will provide you with another privacy notice that explains how we deal with your personal data whilst you are working for us.
I confirm that the information given in this application and any attachments is factually correct and complete and I understand that any false information may, in the event of employment, result in dismissal or disciplinary action by the PACE Centre.
Signed: / Date: //
Please note, you will be asked to sign this form if you are invited to an interview.

Please email your completed form to r send to HR Department, The PACE Centre, Philip Green House, Coventon Road, Aylesbury, Bucks HP19 9JL

If you have not been contacted within 3 weeks of the closing date, you must assume that your application has, on this occasion, been unsuccessful.

Job applicant privacy notice

As part of any recruitment process, the Pace collects and processes personal data relating to job applicants. Pace is committed to being transparent about how it collects and uses that data and to meeting its data protection obligations.

What information does the Pace collect?

Pace collects a range of information about you. This includes your name, address and contact details, including email address and telephone number;

details of your qualifications, skills, experience and employment history;

information about your current level of remuneration, including benefit entitlements;
whether or not you have a disability for which the Paceneeds to make reasonable adjustments during the recruitment process; and
information about your entitlement to work in the UK.

Pace may collect this information in a variety of ways. For example, data might be contained in application forms, CVs or resumes, obtained from your passport or other identity documents, or collected through interviews or other forms of assessment, (including online tests].

Pace may also collect personal data about you from third parties, such as references supplied by former employers, information from employment background check providers and information from criminal records checks. Pace will seek information from third parties only once a job offer to you has been made and will inform you that it is doing so.

Data will be stored in a range of different places, including on your application record, in HR management systems and on other IT systems (including email).

Why does the Pace process personal data?

Pace needs to process data to take steps at your request prior to entering into a contract with you. It may also need to process your data to enter into a contract with you.

In some cases Pace needs to process data to ensure that it is complying with its legal obligations. For example, it is required to check a successful applicant's eligibility to work in the UK before employment starts.

Pace has a legitimate interest in processing personal data during the recruitment process and for keeping records of the process. Processing data from job applicants allows Pace to manage the recruitment process, assess and confirm a candidate's suitability for employment and decide to whom to offer a job. Pace may also need to process data from job applicants to respond to and defend against legal claims.

Pace may process special categories of data, such as information about ethnic origin, sexual orientation or religion or belief, to monitor recruitment statistics. It may also collect information about whether or not applicants are disabled to make reasonable adjustments for candidates who have a disability. Pace processes such information to carry out its obligations and exercise specific rights in relation to employment.

For some roles, the Pace is obliged to seek information about criminal convictions and offences. Where the Pace seeks this information, it does so because it is necessary for it to carry out its obligations and exercise specific rights in relation to employment.

Pace will not use your data for any purpose other than the recruitment exercise for which you have applied.

Who has access to data?

Your information may be shared internally for the purposes of the recruitment exercise. This includes members of the HR and recruitment team, interviewers involved in the recruitment process, managers in the business area with a vacancy and IT staff if access to the data is necessary for the performance of their roles.

Pace will not share your data with third parties, unless your application for employment is successful and it makes you an offer of employment. Pace will then share your data with former employers to obtain references for you, employment background check providers to obtain necessary background checks and the Disclosure and Barring Service to obtain necessary criminal records checks.

Pace will not transfer your data outside the European Economic Area.

How does the Pace protect data?

Pace takes the security of your data seriously. It has internal policies and controls in place to ensure that your data is not lost, accidentally destroyed, misused or disclosed, and is not accessed except by our employees in the proper performance of their duties.

For how long does the Pace keep data?

If your application for employment is unsuccessful, Pace will hold your data on file for 6 months after the end of the relevant recruitment process. If you agree to allow Pace to keep your personal data on file, the Pace will hold your data on file for a further 6 months for consideration for future employment opportunities. At the end of that period or once you withdraw your consent, your data is deleted or destroyed.

If your application for employment is successful, personal data gathered during the recruitment process will be transferred to your personnel file and retained during your employment. The periods for which your data will be held will be provided to you in a new privacy notice.

Your rights

As a data subject, you have a number of rights. You can:

access and obtain a copy of your data on request;

require the Paceto change incorrect or incomplete data;
require the Paceto delete or stop processing your data, for example where the data is no longer necessary for the

purposes of processing; and

object to the processing of your data where the Pace is relying on its legitimate interests as the legal ground for processing.

If you would like to exercise any of these rights, please contact the data protection lead Ian Sansbury on

If you believe that the Pace has not complied with your data protection rights, you can complain to the Information Commissioner.

What if you do not provide personal data?

You are under no statutory or contractual obligation to provide data to Pace during the recruitment process. However, if you do not provide the information, Pace may not be able to process your application properly or at all.

Automated decision-making

Recruitment processes are not based solely on automated decision-making.