APPLICATION

for the post of:

VILLAGE AGENT

Name:

  • Please use this form or download the form from our website () and complete in black type.
  • We use a scoring system to support our selection process. Please pay particular attention to the section asking you to describe how you satisfy the ‘essentials’ and ‘desirables’ in the person specification.
  • Please email completed forms to by the deadline date and time

Closing date for applications:5pm, Friday20thApril 2018

Surname: Forenames(s):

Address:

Post Code:

Telephone Number- Home:

Work:

Mobile:

E mail:

PERSONAL DETAILS

Where did you see the post advertised or learn about it?

If successful, how quickly could you take up the appointment?

Rehabilitation of Offenders Act 1974 (Exceptions Order 1975).

Please ensure you complete this section of the form.

As the Village Agent project includes working with vulnerable adults, all posts are exempt from the Rehabilitation of Offenders Act 1974, and any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) by SI 2013 1198 must be disclosed. The amendment in 2013 removed the requirement for specific types of old and minor convictions and cautions to be disclosed.

The West of England Rural Network will ask all successful job applicants to apply for an enhanced Disclosure and Barring Service (DBS) check, including the ‘adult barred list’.


The check will provide details of an individual’s convictions, cautions, reprimands or warnings recorded on police central records and includes both ‘spent’ and ‘unspent’ convictions together with any information held locally by police forces that it is reasonably considered might be relevant to the post applied for. The service will also check for whether someone is included in the DBS ‘barred list’ (previously called ISA barred list) of individuals who are unsuitable for working with vulnerable adults.

REFEREES

The names and addresses of two referees are requested who have recent knowledge of the applicant and who can comment authoritatively upon the competence and experience of the applicant in relation to the post for which the application is being made (character references on their own are not sufficient).

One of the referees should, if possible, be a recent or current employer or, if appropriate, a tutor. A reference from your present employers (if appropriate) will be required. However, they will not be approached without your permission.

References will normally be taken up prior to interview unless you specifically request us not to do so.

Name: / Name:
Address: / Address:
Post Code: / Post Code:
Telephone number during office hours: / Telephone number during office hours:
May we approach your referees including your present employer? / Yes / No
EDUCATION
From / To / School/ College/ University / Certificates/ Degrees/ Diplomas obtained
PROFESSIONAL AND/OR JOB RELATED TRAINING
From / To / Institute / Course / Job Qualifications Obtained
EMPLOYMENT HISTORY
Dates
From To / Name Of Employer / Position held / Summary of Duties / Reason for leaving
Please describe here in your own style how well your skills, experience, qualifications and personal qualities satisfy the ‘essentials’ and ‘desirables’ listed in the person specification. Please take them in the order in which they are listed. You may expand on entries in previous sections.
Please explain why you are applying for this post.
Please add anything else relevant to your application and to the post not covered elsewhere. This may include relevant leisure interests, voluntary and community work, holiday activities, and offices and responsible positions held.

I confirm that to the best of my knowledge the information given on this form is true and correct. I understand this information provides part of the basis of any subsequent contract of employment. If I am appointed, personal information about me may be computerised for personnel/administration purposes.

Signed:
Date:

Now please complete the Equal Opportunities Monitoring Form, which will be detached from the application form before short listing of candidates takes place
West of England Rural Network

Equal Opportunities Policy – Monitoring

In Confidence

West of England Rural Network is an equal opportunity employer. Equal opportunity is about good employment practices and efficient use of our most valuable asset, our employees. West of England Rural Network will not discriminate on grounds of sex, sexual orientation, age, religion or belief, marital status, ethnic origin, colour, nationality, disability or other grounds of discrimination not prohibited by legislation.

Recruitment

Throughout the process of recruitment and selection of staff, West of England Rural Network takes steps to ensure every effort is made to encourage applications from all sectors of the community and to ensure that applications are treated on an equal, unbiased and lawful basis by the use of objective criteria related solely to the responsibilities of the post and of the skills required of the person appointed.

Monitoring

To enable this policy to be monitored and developed further, applicants for new appointments are invited on a voluntary and confidential basis to complete the questions set out overleaf. Please note that this form will not be used in the consideration of applications for short-listing or appointment.

Please see following page for questions to be completed.

Title of Post: Village Agent

Date:

Monitoring Ethnicity

How would you describe yourself?

Choose ONE section for A to E, and then tick the appropriate box

A White

British

Irish

Scottish

English

Welsh

Any other white background, please write in box

B Mixed Heritage

White and Black Caribbean

White and Black African

White and Asian

Any other mixed background, please write in box

C Asian or Asian British

Indian

Pakistani

Bangladeshi

Any other Asian background, please write in box

D Black or Black British

Caribbean

African

Any other Black background, please write in box

E Chinese or other ethnic group

Chinese

Any other, please write in box

F Prefer not to say

Disability Monitoring

Do you consider yourself to have a disability or long-term health condition?

Yes No

What is the effect or impact of your disability of health condition?

Prefer not to say

Gender Monitoring

Would you describe yourself as:

Male Female?

Age Monitoring

What is your date of birth?

(dd/mm/yyyy)

Prefer not to say