Job Reference Number Application for the Post Of

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Job reference number
Application for the post of

You should complete all sections of this form in black ink or typeface. Use continuation pages where allowed and clearly mark which questions they refer to. Please put your full name at the top of each continuation sheet. Sections which do not apply to you should clearly be marked N/A. CVs will not be accepted as part of the application process.

If you have a disability and feel you may be unable to comply with any of the above please contact the relevant personnel section. This application form is available in Braille, large print and on audiotape by request. For this service ONLY, please contact the Braille Bureau at Nottinghamshire County Council on 0115 977 3157.

Data Protection Act 1998

The information you provide in this application form will be entered into a manual filing system and onto a computerised recruitment system and as such is covered by the rules set out by the Data Protection Act 1998.

SECTION 1

Personal details (see note 1)
Surname / Surname at Birth
(if different)
Forename(s) / Title (Mr, Ms, Mrs, Miss, Dr) / Any other name(s) you are known by/have used previously
Town and country of birth
Current address
Postcode / Is this address multi-occupancy? (Non-family members) Yes No
Date of occupancy (month/year) / Email address

Telephone numbers

(including area code) / Home / Work (if convenient)
Mobile
National Insurance number

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Nationality(see note 2)
What is your nationality?
If you are a Commonwealth citizen or a foreign national, is your stay in the UK free of restrictions?
Yes No

If you are a Commonwealth citizen or a foreign national, you must include a copy of your passport which shows your stay in the UK is free of restrictions

Photocopy of passport included? Yes No

Have you resided in the United Kingdom for the past three years consecutively?

Yes No

To be eligible for appointment you must be a British citizen or a member of the EC or other states in the EEA (Iceland, Norway, Liechtenstein). Commonwealth citizens and foreign nationals are also eligible but only if they are resident in the UK free of restrictions.

Access to transport
Do you hold a current driving licence? Yes No
Provisional Full
Licence number
Do you have access to private transport? Yes No

VETTING INFORMATION

Name

Title (Dr/Mr/Mrs/Ms/Miss)

Application for the post of

Job reference number

Previous addresses

Please give all addresses at which you have lived over the last five years.Start with the most recent. Do not include your current address. Continue on a separate sheet if necessary.

Full address
(include postcode, if known) / Approximate dates
from (month/year) to (month/year)
1.
Multi-occupancy Yes No
2.
Multi-occupancy Yes No
3.
Multi-occupancy Yes No
About your family(See note 3)

Please tell us about your family (wherever they live), and any other adults living at your address. Continue on a separate sheet if necessary. Please complete all sections or your application will be delayed.

Relationship to you
(delete as appropriate) / Full name
(include any previous surnames and name at birth if different) / Full address
(including postcode if known)
You
Date and place of birth
Your spouse or partner
Date and place of birth
Your father
Date and place of birth
Your stepfather or mother’s partner
Date and place of birth
Your mother
Date and place of birth
Your stepmother or father’s partner
Date and place of birth
Your brother or sister
(Full/half/step etc)
Date and place of birth
Your brother or sister
(Full/half/step etc)
Date and place of birth
Your brother or sister
(Full/half/step etc)
Date and place of birth
Your brother or sister
(Full/half/step etc)
Date and place of birth
Your spouse’s or partner’s mother/ stepmother etc
Date and place of birth
Your spouse’s or partner’s father/ stepfather etc
Date and place of birth
Your child/ child of partner
(only state if aged 10+)
Date and place of birth
Your child/child of partner
(only state if aged 10+)
Date and place of birth
Your child/child of partner
(only state if aged 10+)
Date and place of birth
Other adults living at your address (eg.lodger)
Date and place of birth

As part of the vetting process applicants should advise all relevant family members (their spouse/partner, co-habitee, parents, brothers, sisters and step-relatives) that their details have been included in this application.

Convictions and cautions
(it is important that you read note 3 before you complete this section)

Have you been convicted for any offence or had any formal cautions/reprimand by police (including Military Police) for any offence or any bind-over imposed by any court? (include traffic convictions, other fixed penalty notices eg. public order, drunkenness and appearances before a court martial and any cautions as a juvenile.)

Yes No

If you have answered YES, please enter details below

Date Offence/ Result Court/police station involved

(most recent first) Alleged offence (if known)

Do you have any pending prosecutions? Yes No

If yes please provide full details as above

Have you ever been involved in a criminal investigation or been arrested (whether or not this led to any prosecution to yourself or others) or been associated with criminals?

Yes No

If YES, please give details below

ALL QUESTIONS RELATE TO APPLICANTS AND, IF APPLICABLE, THEIR SPOUSE OR PARTNER.

Unless otherwise stated, complete these questions in respect of the last six years.

Pre-employment financial information(see note 5)
Yes No / Show full information in respect of all questions.
Failure to do so could delay your application.
Have you had a loan arrangement terminated by a bank/building society/finance house?
Have you had a credit/charge
card withdrawn?
Are you in arrears with any
existing loan/mortgage/hire purchase agreement?
Have you ever been registered
bankrupt?
If YES, have your bankruptcy
debts been discharged? *
Have your had any court action
taken against you for any debt?
Have you been party to a
voluntary agreement registered
with the County Court?
Has a County Court/Tribunal
Judgement been made against you?
If YES, has this been cleared? *
Have you had repossession
proceedings commenced
against you?
Have you consolidated your debt with one lender?
*If applicable, please provide a Certificate of Satisfaction.
Declaration
I consent to the information contained in this questionnaire being submitted for checking against the records of the Police National Security and credit reference agencies. I understand that the information I have provided will be treated in the strictest confidence.
I confirm that my spouse/partner and other parties/persons named are aware that his/her details have been provided as part of the vetting process.
I declare that the information I have provided is true and complete to the best of my knowledge and belief.
I undertake to notify any significant changes or additions in the information I have provided in this form.
I understand that if I have knowingly made a false statement or deliberate omission in the information I have provided in this form, my application may be rejected.
Signature Date

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SECTION 2

Present or most recent employment(see note 6)
Full name and address of
most recent employer
(including postcode) / Date
from/to / Position held
and duties / Reason for leaving/
wanting to leave
Period of notice required
Working Time Regulations
Do you have a continuing commitment to work for other employer(s)/voluntary organisations?
Yes No
If Yes how many hours on average each week?
Please identify the organisation
Business interests (see note 6)
Do you currently have any job or business interests that you intend to continue should your application be successful? Yes No
If YES, please state the nature of this job or business and the extent of your involvement (eg. actively involved, non-executive director). Include number of hours contribution.
Previous employment (see note 6)

Start with the most recent (Continue on a separate sheet if necessary)

Full name, address and nature of business (includingpostcode and email if known) / Date
from/to / Position held
and duties / Reason for
leaving

SECTION 3

Your education(see note 7)

Please give details of schools, colleges, university or other establishments attended, which are relevant to the post. Start with the most recent/current and work backwards. Continue on a separate sheet if necessary.

Full name and address of school/college/university (include telephone number and postcode if known) / Attendance
from/to / Qualifications gained
(state subjects and grade/level) / Full/ part-time
Your qualifications and training

Please list all other relevant qualifications including vocational and professional qualifications, short courses and in-house training. Please list any specialised training and membership of any professional bodies. Also include details of qualifications due to be taken. Start with the most recent.Continue on a separate sheet if necessary.

Examination/Association / Date / Stages passed/level of membership

Please note

Original documentary evidence of qualifications and/or professional registration/membership will be required at interview.

Your other activities

Please tell us about any other skills you have such as driving or language and any voluntary or community activities you have been involved in.

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Information in support of your application (see note 8)

In order to give the best opportunity to be shortlisted, you should complete this section as fully as possible giving evidence of special skills, training and experience relevant to the post,in line with the person specification. Continue on a separate sheet if necessary.

Information in support of your application (Continuation Sheet)

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Referees

Please give names and addresses of two referees, one of whom MUST be your present or last employer. If you do not have a last or current employer then an academic establishment reference or that of a person who has known you for a considerable length of time (for at least two years) will be acceptable. Please note that we will contact your employers for references covering the last three years, even if you have not listed them as a referee.

Referee 1
Name
Address
Position held/relationship (if not employer)
Telephone
May we contact this referee now?
Yes No / Referee 2
Name
Address
Position held/relationship (if not employer)
Telephone
May we contact this referee now?
Yes No
HM Forces
Please give details of any Reservist Liabilities (including TA)
Please note that this information is purely for statistical purposes and does NOT form any part of the selection process.
Membership of BNP or similar (see note 9)
Are you or have you ever been a member of the BNP or similar organisation whose constitution, aims, objectives or pronouncements may contradict the duty to promote race equality? / Yes No

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SECTION 4

Declaration
I declare that all the statements made in this document are true to the best of my knowledge and belief, and understand that any false or misleading statement or omission, may render me if appointed liable to subsequent disciplinary proceedings, including dismissal.
I understand that:

1. I must inform the relevant personnel department without delay of any change in my circumstances.
2. The information I have provided may be held on both manual and computerised systems as part of the recruitment process.

Date Signature of applicant
Selection appeals procedure
Nottinghamshire Police operates a Selection Appeals Procedure. If you wish to appeal against any decision made, please notify the Departmental/Divisional HR Manager at the address detailed in the advert within 10 working days of your selection process or alleged act/discovery of the omission being questioned. If you do make an appeal, please state the title of the post, department and location of the post being applied for, together with a brief outline of the basis of your appeal.

CHECKLIST

Read through your completed application form carefully

• Ensure it is clearly presented and you have answered all the questions, marking them not applicable (N/A) where appropriate.
• Failure to provide accurate and complete information may result in your application being delayed or rejected.
• If you have additional relevant information please feel free to include this in your application.
• If, after reading through the recruitment material, you have any remaining questions, please contact the personnel team responsible for the vacancy.
• Remember to take a photocopy of your completed application form. Should you require a copy of your application after the closing date, a Data Protection request will need to be submitted. A charge is levied for this service.

Before returning your application form please check you have done the following

• Have you included a telephone number at which you can be contacted?
• If you are a Commonwealth citizen or a foreign national, have you included a photocopy of your passport with evidence that your stay here is not subject to restrictions?
• Have you signed the security vetting and financial declaration (Page 8) and further general declaration on this page?
• Have you completed the Equal Opportunities Monitoring Form?
• Have you completed (where appropriate) the Competency Based Questionnaire?

Availability for interview
Please state any dates within the next 12 weeks when you are not available to attend for interview

Please return application form to address as shown in the covering letter

EQUAL OPPORTUNITIES MONITORING FORM

Name

Title (Dr/Mr/Mrs/Ms/Miss)

Application for the post of

Job reference number

Policy statement
Nottinghamshire Police is committed to providing equality of opportunity in terms of employment. The Policy Statement applies to all staff and applicants regardless of race, sex, pregnancy and maternity, marital status, colour, nationality, religion or belief, sexual orientation, gender reassignment, age or disability. This commitment applies to all issues affecting recruitment, training, transfer and promotion including terms and conditions of service.
To assist us in assessing the effectiveness of this policy and only for this reason, please complete the following details. This information will NOT be used in deciding your suitability for the post.
Date of birth
Age 16-25 26-35 36-45 46-55 56 and over
Sex Male Female Other
Disability Yes No
Race
White British Irish Any other white background
Mixed White and Black Caribbean White and Black African
White and Asian Any other mixed background
Asian or
Asian British Indian Pakistani Bangladeshi Any other Asian background
Black or
Black British Caribbean African Any other Black background
Chinese
other ethnic group Chinese Any other (please specify)
Sexual orientation
Bisexual Gay Heterosexual Prefer not to say
Religion or belief
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
None
Prefer not to say
Other (please state)
Marketing form
To enable us to monitor our public relations and marketing activity, please indicate how you heard about this vacancy. Tick any that apply.
Police Officer or other police service employee
Friend/family/other word of mouth
Careers office/school/college/library
Jobcentre Plus (please state which)
Website (please state which site)
Other advertisements, articles, interviews
In local press (please state publication)
In national press (please state publication)
On radio (please state station)
At local event (please state venue)
Recruitment poster/ leaflet (please state where)
Nottinghamshire Police Positive Action evening
Job Assistance Scheme (JAS)
Other (please specify)
Please give details of any other media, interviews or articles, which prompted your application.

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POLICY FOR

EQUAL OPPORTUNITIES EMPLOYMENT

Nottinghamshire Police is committed to providing equality of opportunity in terms of employment.

This Policy Statement applies to all staff, regardless of race, sex, pregnancy and maternity, marital status, colour, nationality, religion or belief, sexual orientation, gender reassignment, age or disability.

In addition any member of staff who feels aggrieved for any other reason may use the Fairness at Work Policy to raise their concern.

In matters of employment equality of opportunity will extend to all issues affecting recruitment, training, transfer and promotion, including terms and conditions of service. Selection criteria, systems and procedures will be kept under review, to ensure that individuals are selected or promoted objectively on the basis of their skills and abilities, according to the requirements of the job.

Nottinghamshire Police is committed to this policy and to the development and of Positive Action initiatives to ensure that the policy is, and continues to be fully effective.

The main aim of Nottinghamshire Police is to provide a work environment where each individual is recognised, valued and accepted.

Every effort will be made to ensure that fair, non-discriminatory practices are applied to and by all staff in their dealings with each other.

All staff of Nottinghamshire Police must be aware of their obligations under anti-discrimination legislation and particularly the legal requirement that individuals shall not unlawfully discriminate or aid, instruct or induce others to do so. Eliminating discrimination and providing equality of opportunity depends upon personal commitment and all staff without exception, must observe anti-discrimination principles, related policies and notes of guidance. Training courses and other sources of information will be provided, where appropriate, to broaden and promote a greater understanding and awareness of these issues and personal responsibilities.