Where did you see this role advertised? / Head of Programmes - Maternity Cover
1.Personal Details
Surname: / Forenames:Address:
Email: / Contact Phone Number:
Daytime:
Evening:
Mobile:
2.Referees
Please give the names of two people who have agreed to give you a reference. At least one referee should be familiar with your most recent employment. We may contact them before interview unless you state otherwise.
Name:Position:
Contact Phone Number:
Contact Email:
In what context do you know this referee? / Name:
Position:
Contact Phone Number:
Contact Email:
In what context do you know this referee?
3.Details of Present or Most Recent Employment
Employer’s name and address:Dates: from…………….. to……………….. / Job title:
Salary:
Duties/Achievements:
4. Employment History
Name & address of previous employer:Job title:
From: To:
Duties/achievements
Name & address of previous employer:
Job title:
From: To:
Duties/achievements
For any further employment information preceding the past 10 years and deemed relevant, please insert additional space.
5.PostSchool Education and Training
Institution: / From:To: / Qualifications Obtained:
Details of any training courses undertaken or membership of any professional bodies:
6. Other relevant experience and interests (e.g. voluntary work, other skills etc.)
7. Supporting Statement
Please study the job description and person specification carefully and in not more than 800 words
a)Summarise the skills, knowledge and experience that you would bring to this post. You MUST address each point in the person specification and show how your personal or professional experience meets the requirements of this post
b)Give your ideas on how to take this post forwards
c)Indicate why you want this post and what it offers you professionally and personally.
ICT operates a Child Protection Policy and employees undergo an enhanced disclosure with the Disclosure and Barring Service.
IF YOU ARE INVITED TO INTERVIEW PLEASE PRINT OUT YOUR APPLICATION AND SIGN THE DECLARATION BELOW
I confirm that that all information given in this application is correct to the best of my knowledge.
Signed:Date:
Equal Opportunities Monitoring Information
If you require this document in an alternative format, please contact Angela Buckland on 020 7065 0973 or email
International Childcare Trust believes in equal opportunities and works actively to promote them in our work.
We want to make sure that we are an equal opportunities employer in practice, which is why we want to monitor our recruitment procedures. We will separate this part of the form from your application. It will not form part of the selection process.
Please tick the appropriate boxes. If you would prefer not to answer any questions, please leave the box blank.
What gender are you?
Male Female
What age group do you belong to?
18-25 25-35 35-45 45-55 over 55
Do you consider that you have a disability?
Yes No Please give details______
How would you describe your religion?
My faith is ______
I am not religious
How would you describe your nationality?
British English Scottish Welsh Irish
Other (please describe) ______
Please turn over...
How would you describe your ethnic origin?
Tick the classification which would best describe your ethnic origin. This term refers to different racial groups and not to your nationality, country of birth or religious affiliations. The classifications given below are based on those used in the 2001 National Census. If you feel that you do not fall within these categories, please indicate under ‘Any other..’ ..‘ what you consider to be your ethnic origin’.
White:
BritishWhite Other, please specify:
Any Other White background, please specify:
Mixed:
White & Black Caribbean / White & Black African / White & AsianAny Other Mixed background, please specify:
Asian or Asian British:
Indian / Pakistani / BangladeshiAny Other Asian background, please specify:
Black or Black British
Caribbean / AfricanAny Other Black background, please specify:
Chinese, Chinese British or any other ethnic group:
ChineseAny Other background, please specify:
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