FIRST STAGE – WORK EXPERIENCE

APPLICATION FORM

Please complete this form in black ink or type, providing information relevant to the placement for which you are applying. By submitting this form you confirm that the information provided is correct, to the best of your knowledge, and you give your consent for the Royal Opera House to hold and process this information in accordance with the Data Protection Act 1998. Your details may be held on file for up to six months.

TITLE OF PLACEMENT
PREFERRED DATE OF PLACEMENT
SURNAME
FIRST NAMES
CONTACT ADDRESS
TELEPHONE NUMBER (HOME)
TELEPHONE NUMBER (MOBILE)
EMAIL ADDRESS
DATE OF BIRTH*
SECONDARY EDUCATION
School/College name / GCSE/A Level
(or other course title) / Grade Received/ Predicted / Dates Attended

*This information is required to confirm whether or not you meet the minimum age criteria necessitated by Health & Safety legislation for certain placements.

FURTHER EDUCATION
College/University name / Course Title / Grade Received/ Projected / Dates Attended
OTHER RELEVANT TRAINING(Continue on a separate sheet if necessary).
Name of training provider / Course Title / Grade Received/ Projected / Dates
RELEVANT WORK EXPERIENCE (employment, volunteer positions, previous work experience, etc.)
Please list the most recent first.
Position
Organisation’s Name
Dates
Description of responsibilities
RELEVANT WORK EXPERIENCE (continued). Continue on a separate sheet if necessary.
Position
Organisation’s Name
Dates
Description of responsibilities
Hobbies, interests and any other relevant skills and experience.
Why are you applying for this particular work experience opportunity with the ROH?
What do you expect to gain from this experience in order to achieve your career goals?
SUPPORT FROM SCHOOL/COLLEGE OR PARENT/GUARDIAN
If you are under 18, this section must be completed by a representative from your school/college or your parent/guardian to confirm their support for your application.
A formal consent form will be sent to this person should an offer of a placement be made.
Name:
Relationship to applicant:
Address:
Telephone:
Email:
Signature: / Date:
EMERGENCY CONTACT DETAILS
Please provide the contact details of the person we should contact in the unlikely situation of an emergency occurring while you are on work experience. Where appropriate, this should be a representative from your school in the first instance.
Name:
Relationship to you:
Telephone (daytime):
Telephone (mobile):
Email:
Address:
Do you have right of abode in theUK? Yes  No 
Applicant’s Signature: / Date:

CONFIDENTIAL

FIRST STAGE – WORK EXPERIENCEEQUAL OPPORTUNITIES QUESTIONNAIRE

This information is requested for monitoring purposes only. It is not available to, or used by, the selection panel.

Do you consider yourself to have a disability? Yes No 
If yes, please describe any special adjustments required in relation to your interview?
In accordance with the Disability Discrimination Act 1995, a disability is considered to be a physical or mental impairment which has a substantial and long term adverse effect on your ability to carry out normal day to day activities and you think might disadvantage you in obtaining or keeping employment for which otherwise you would be suitable, even though you might have overcome any such disability.
Where did you first hear about this opportunity?
ROH website  Other website 
Internal advert  Word of mouth  Other  If other please specify …………………………….

PLEASE RETURN THIS COMPLETED FORM TO:

First Stage, Personnel Department, Royal Opera House, Covent Garden, London WC2E 9DD