Ashley Road, Bradford on Avon, Wiltshire BA15 1DZ
Administration: 01225 860110
Fax: 01225 860111
Email:
JOB APPLICATION FORM
Head of Creative Learning
All sections of this form must be completed fully please. All information will be treated as strictly confidential and no approach will be made to any person without your permission. Please print clearly.
Completed applications on this form (no CVs) must be received by post or email to by 5pm on 30 September 2016, interviews will be held during the week of 10 October 2016
SECTION ONE: PERSONAL DETAILS
Full NameTitle
Home Address
Telephone (home)Telephone (work)
SECTION TWO: PRESENT POST
Job Title
Brief details of responsibilities
Employer, place of work and location
Date of Appointment
Gross Salary
Notice Period
Reason for wanting to leave present post
SECTION THREE: OTHER EMPLOYMENT
Please give details of all posts, including dates, nature of employment and your responsibility.
Please account for any gaps in employment history to provide an unbroken record (use extra sheets if needed)
Other previous relevant experience
SECTION FOUR: EDUCATION AND TRAINING
Please give details of school, college etc and all educational qualifications:
Other relevant training courses undertaken:
SECTION FIVE: RELEVANT EXPERIENCE
Please explain below how your skills and experience will enable you to deliver this role.
SECTION SIX: LEISURE PURSUITS
(Please give brief details of your interests)
SECTION SEVEN: OTHER INFORMATION
Do you have a current UK driving licence? Yes / No
Do you own or have ready access to the use of a car? Yes / No
Have you in the past 12 months had a period of illness or injury resulting in a long term absence from work (i.e. more than 4 weeks)? YES/NO
(If yes please give details)
Do you have a DBS Clearance? YES NO
If Yes, please give your Reference No.
SECTION EIGHT: REFEREES
Please give the name, address, phone /fax numbers and email addresses of two people who may be asked about your personal and professional qualities. One MUST be your current employer (or last employer if now unemployed). Please state how the person is known to you. References are taken up after interview, and just occasionally beforehand unless otherwise requested.
Name
Address
Tel No:
Email address:
Name
Address
Tel No:
Email address:
DECLARATION
1. General. I declare that the information I have given on this form is correct and that any misrepresentation by me may be sufficient grounds for my dismissal if I am employed. I give my permission for my previous employer/s and any referees to be contacted.
2. Checks with Criminal Records Bureau (CRB). As the Wiltshire Music Centre works with children, I am aware that if I am selected for this job I shall be required to give the Trust consent to institute a Disclosure check with the CRB. All employees at the Wiltshire Music Centre are required to be checked to the Enhanced level. This post is exempt from the Rehabilitation of Offenders Act 1974 and therefore all convictions, cautions and bind-overs, including those regarded as "spent", must be declared. Selection for employment will be dependant on satisfactory references, CRB check and medical.
3. Consent under the Data Protection Act 1998: Please note that the information given to the Wiltshire Music Centre Trust in this form will be processed only by the Trust for the purpose of considering your application for employment. If you are successful in your application, this form and the information in it will be retained in your personnel file for such time as you are an employee of the Wiltshire Music Centre Trust and for up to 6 years after the end of your employment. Otherwise this form will only be retained by the Trust for so long as it is required in connection with your application. By signing this consent you give us your express consent to retain and process all the information contained in this form.
Signed by Applicant: ……………………………………….... Date: …………………………………..
Equal Opportunities
Wiltshire Music Centre is committed to promoting equality of opportunity and inclusion across the organisation’s work. To achieve this, the organisation understands and approaches diversity in its broadest and inclusive sense. This includes differences defined by social and cultural categories including gender, religion, sexual orientation, disability, ‘race’ and age.
The organisation further acknowledges differences that cut across social and cultural categories but are equally significant to equality of opportunity and inclusion such as health, education, economic and material disadvantage.
Equal Opportunities and Diversity monitoring form (2 pages) – please return with your application
Recruitment and selection procedures are monitored to ensure that individuals are selected on merit and that there is no unfair treatment. This data is collected solely for equality monitoring and will not be used as part of the selection process.
Your reply will be treated in confidence (this sheet will be removed before any assessment of your application takes place). You are under no obligation to answer all the questions below.
Position applied for: ......
How did you hear about the role?:......
______
Age
How old are you? (please circle):
Under 20 20-29
30-39 40-49
50-59 60+ Prefer not to say ……….
......
Disability
In general, a person is considered disabled for the purposes of the Equality Act 2010 if he or she has a physical or mental impairment which has a substantial, long-term and adverse effect on his or her ability to carry out normal day-to-day activities.
Do you consider yourself to have a disability? (please circle):
Yes No Prefer not to say ……….
......
Gender
Are you (please circle):
FemaleMale Prefer not to say ……….
......
Sexual orientation
Which sexual orientation category best represents you? (please circle):
Lesbian Gay
Bisexual Heterosexual Prefer not to say ……….
……………………………………………………….
Religious belief
Do you have a religious belief? If so, please state what it is:
...... Prefer not to say ……….
Monitoring Ethnicity
Please select the ethnic category that best represent you. As you make your decision, please think about what ethnic group means to you, that is, how you see yourself. Your ethnicity is a mixture of culture, religion, skin colour, language and the origins of yourself and your family. It is not the same as nationality.
A White
British
Any other White background, please state ......
------
B Asian or Asian British
Bangladeshi
Indian
Pakistani
Any other Asian background, please state ......
------
C Black or Black British
African
Caribbean
Any other Black background, please state ......
------
D Chinese or other ethnic group
Chinese
Any other, please state ......
------
E Mixed Heritage
Asian and White
Black African and White
Black Caribbean and White
Chinese and White
Any other Mixed background, please state ......
F Prefer not to say ……….
Thank you – please include this form with your application
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