No Late Applications Will Be Considered Whatever the Reason

/ APPLICATION FORM
CONFIDENTIAL
This form is also available in Welsh
PLEASE RETURN THIS FORM TO:
Human Resources
Isle of Anglesey County Council
Council Offices
Llangefni
Ynys Môn
LL77 7TW
OR EMAIL: /
For office use only:
Applicant Number:
Date Received:
VACANCY REFERENCE NUMBER:
POST APPLYING FOR:
DEPARTMENT:
NOTESFORCANDIDATES PLEASE USEBLACKINKORBLACKTYPE

• No late applications will be considered whatever the reason.
• Please be advised that it is not our current policy to acknowledge application forms. We will write to you should you be successful in being short-listed for interview.
• Referees of short-listed candidates will be approached for references.
• Canvassing disqualifies.

1. PERSONAL DETAILS
Please confirm which language you would like to receive future correspondence
Welsh English
The Authority welcomes correspondence in Welsh and corresponding in Welsh will not lead to any delay
Surname
First Names
Mr/ Mrs/ Miss/ Ms/ Dr/ Other
Addressfor Correspondence
(Please includePostcode)
Daytime/ EveningTelephoneNo.
MobileTelephone No
E mail Address
Anyothernamebywhichyouhavebeenknown
NationalInsuranceNumber
2. PRESENT OR MOST RECENT EMPLOYMENT
NameofEmployer / Organisation
Address
Job Title
Date Employed
Salaryand other remunerationdetails
Towhomimmediatelyresponsible
Briefdescriptionofduties
Reasonfor leaving (ifapplicable)
Notice required
3. PREVIOUSWORKEXPERIENCE
Please startwith mostrecentexperienceandaccountfor anybreaksin employment.You maycontinueona separatesheetifnecessary.
From / To / Organisation Name and Location / Your Position and Remuneration Detail / Brief Descriptions of Duties and Reason for Leaving
4. EDUCATION AND TRAINING
Please Note:Youwillbe required toprovideevidenceof anyqualifications/membershipofprofessional/regulatorybodiesthatare essential for thepostyou areapplying for.
Educational Establishment
AcademicQualifications(Pleaseprovide gradeswhereapplicable) / Subject / Grade / Date
Other skills
Give details of anyother relevantcertificates/diplomas or coursesattended,notincludedabove.
Are you currently studying? Yes / No
Date of Completion / Course TitleCollege / Qualification
Areyou a member of a
professional organisation? Yes / No
Date / Name of Professional Organisation / Level of Membership
5. WHY ARE YOU APPLYING FOR THIS POST
Pleaseexplain howyourskills,experienceandaptitudesmakeyousuitablefor thispositionandwhythis jobis ofinterest toyou,giving evidence ofprovenexperienceagainstthecriteria notedin thepersonspecification.Youmaycontinueon a separate sheet(s) if necessary.
Continued (if necessary)……
6. INTERVIEW INFORMATION
All applicants who have a disability and meet the minimum criteria for the post will be offered an interview in line with the Isle of Anglesey County Council’s commitment to providing opportunities for people with a disability
Are there any dates on which you would NOT be available for interview?
If yes, please confirm dates you are NOT available: / Yes No

In which language would you prefer your interview to be conducted?
Welsh English
7. DRIVING DETAILS
Do you hold a full valid driving licence? / Yes No
Do you own a car? / Yes No
8. RELATED
Are you related to any Elected Member or Senior Employee of Anglesey County Council?
If yes, please give details: / Yes No

9. REHABILATION OF OFFENDERS ACT 1974 (EXCEPTIONS) ORDER 1975 & POLICE ACT 1997
Please givedetails of anyconvictionsor chargesoutstandingofalloffences (orallegedoffences) including driving offences.Ifyouinadvertentlydisclose aconviction,which is regardedas ‘Spent’ it will be ignored.
If the Job Descriptions of the post you are applying for indicates that the post is subject to a Disclosure & Barring check, you must reveal any criminal convictions, bind-over orders or cautions, including those which would normally be regarded as spent.
Ifyoufailto give us relevantinformationor give false informationthis mayresult in anyoffer ofemploymentbeing withdrawnor if alreadyin employment,disciplinaryaction anddismissal.
10. ASYLUM AND IMMIGRATION ACT 1996
Under theImmigration,AsylumandNationalityAct 2006theCouncil hasa responsibilitytoensurethatonlythoselegallyentitledtoliveandworkin theUnitedKingdom areofferedemployment.Inobservingthis Act youwill need toproducedocumentationwhichconfirmsyourentitlement.
Do you need permission to work in the UK
If yes, is this time limited
If yes, what is the expiry date? /
Yes No
Yes No

11. REFERENCES
Please give name,fullpostaladdresses,email and contacttelephonenumberoftworeferees,oneofwhom shouldbeyourpresent or immediatepastemployer.
Referenceswill be takenupfor shortlistedcandidatesonlyandanyoffer ofemployment issubjecttoreferencesthattheCouncil deemssatisfactory.
For insurancepurposes, if you areappointed we are required to takeup referenceswith all yourpreviousemployerswithinthreeyearsof thedate ofthisapplication.For regulatedactivitypostswe are required to contact all previousemployers whereyouworked in apositionwhichinvolvedworkwith children or vulnerableadults.Detailsofall previousemployers should be listedinSection3.
Name / Name
Job Title / Job Title
Full Postal Address / Full Postal Address
Email / Email
Telephone Number / Telephone Number
Pleasetick the boxprovided ifyou do notwish us tocontactyour refereeswithoutspecificconsent fromyou*
* Pleasenote thatrefereesfor short-listedcandidatesforregulatedactivityposts (dealingwith childrenvulnerableadults)willbecontactedpriortointerview,whichwill not besubjecttoyourconsent.
12. Language Skills
Welsh Language Skills (Please see the skills framework attached)
Listening and Speaking
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Reading
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Speaking
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Writing
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
English Language Skills (Please see the skills framework attached)
Listening and Speaking
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Reading
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Speaking
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Writing
(Tick One) / Level 0
/ Level 1 / Level 2 / Level 3 / Level 4 / Level 5
Where did you see the advert for this vacancy?
I declaretothebestofmyknowledge andbelief,theinformationI havegiven in applying foremployment istrue andaccurate.I understandthatanyoffer oremployment is conditionalupontheaccuracyofthisinformation.
Sign: Date:

Data ProtectionAct 1998

Theinformationgivenmaybeprocessed bycomputerandwill be usedfor recruitmentandselection purposes only.This applicationwillbe keptfor amaximum of6 monthsfollowing therecruitmentprocess,and all successfulapplicants’forms willbecome partof theirpersonnelfile.

PLEASE RETURN THIS FORM TO:

Human Resources, Anglesey County Council, Council Offices, Llangefni, Anglesey, LL77 7TW

or by email to

ISLE OF ANGLESEY COUNTY COUNCIL PRIVACY NOTICE

Human Resources

How we use your information

This privacy notice tells you what to expect when the Isle of Anglesey County Council (IOACC) collects personal information. The Human Resources unit collects your information and will use it only as part of the recruitment process for the purposes of evaluating your suitability for employment, making any reasonable adjustments and for equalities monitoring. Your personal information will be properly safeguarded and processed in accordance with the requirements of the Data Protection Act 1998.

Some of your personal information may also be exchanged with third parties where it is necessary for the purposes of assessment and to carry out pre-employment screening. For example, when obtaining references from previous employers, or requesting a Disclosure and Barring Service check. The information to be collected may include the following:

• Your name;
• Address;
• Signature;
• Email address
• National Insurance No.
• Qualifications
• Previous employment
• Membership of Professional Organisations
• Ethnic Origin
• Disability data
• Religion

If your application for employment is successful, Isle of Anglesey County Council will use your personal information for the purpose of administering your employment. If your application is unsuccessful, Isle of Anglesey County Council will retain your personal information for a period of up to 12 months from the date on which the relevant recruitment campaign is closed.

IOACC will only use the information that it holds to comply with its statutory duties; for example, the collection of council tax or to provide you with a service that you have requested or need.

People who call our helpline

When you call the Council we record your phone number, the date, time and duration of your call. This information is used to monitor service performance in responding to enquiries and is destroyed after 12 months. On occasion, the Council may record your telephone call - this will only take place for training and monitoring purposes or in the event that our staff are subject to abuse. In all cases we will provide you with prior notice of our intention to record the call.

People who email us

The Council is part of the PSN network. Any email sent to us, including any attachments, may be monitored for compliance with the Council Policy. Email monitoring or blocking software may also be used. Please be aware that you have a responsibility to ensure that any email you send to us is within the bounds of the law.

Your rights

You have the right to ask us not to process your personal data for marketing purposes. We will alwaysinform you (before collecting your data) if we intend to use your data for such purposes or if we intend to disclose your information to any third party for such purposes. You can exercise your right to prevent such processing by completing certain boxes on the forms we use to collect your data. You can also exercise the right at any time by contacting us at

Access to personal information

IOACC tries to be as open as it can be in terms of giving people access to their personal information. Individuals can find out if we hold any personal information by making a ‘subject access request’ under the Data Protection Act 1998. If we do hold information about you we will:

• give you a description of it;
• tell you why we are holding it;
• tell you who it could be disclosed to; and
• let you have a copy of the information in an intelligible form.

The Act gives you the right to access information held about you. Your right of access can be exercised in accordance with the Act. Any access request must be in writing and will usually be subject to a fee of £10 to meet our costs in providing you with details of the information we hold about you.

If we do hold information about you, you can ask us to correct any mistakes by contacting the Corporate Information Officer.

Any information we hold about you will be held securely and for no longer than required.

Disclosure of your personal information

In many circumstances we will not disclose personal data without consent. However, when we investigate a complaint, for example, we may need to share personal information with colleagues. Further, from time to time, IOACC, is obliged by law to disclose personal information that it holds for example to the Revenue and Customs, the Police, the Health Services and other agencies.

How to contacts us

For further information on theIsle of Anglesey County Council Privacy Noticeplease contact: Corporate Information Officer, Isle of Anglesey County Council, Council Offices, Llangefni, Anglesey, LL77 7TW.

Tel: 01248 751806

Language Skills – Workplace Assessment Levels

(i) Listening

0 / No skills
1 / Able to understand basic enquiries in Welsh/English
2 / Able to understand a basic social conversation in Welsh/English
3 / Able to follow routine conversations involving work between fluent Welsh/English speakers
4 / Able to follow the majority of conversations involving work including group discussions
5 / Able to understand all conversations involving work

(ii) Reading

0 / No skills
1 / Able to read basic words and phrases, e.g. signs or short and simple notes
2 / Able to read basic material involving work (slowly)
3 / Able to read routine material with a dictionary
4 / Able to read the majority of material in own area
5 / Able to understand all material involving work

(iii) Speaking

0 / No skills
1 / Able to conduct a general conversation [greetings, names, saying, placenames]
2 / Able to answer simple enquiries involving work
3 / Able to converse with someone else, with some hesitancy, regarding routine work issues
4 / Able to speak the language in the majority of situations using some Welsh/English words
5 / Fluent – able to conduct a conversation and answer questions, for an extended period of time where necessary

(iv) Writing

0 / No skills
1 / Able to write basic messages
2 / Able to answer simple correspondence with assistance
3 / Able to draft routine text, with editing assistance
4 / Able to prepare the majority of written material related to the area, with some assistance in terms of revision
5 / Skilled – able to compete written work without the need for revision
EQUAL OPPORTUNITIES MONITORING FORM
The information you have supplied will be kept confidentially and will only be used to provide an overall profile analysis of Anglesey County Council.
We are legally required to monitor for equality, however you are not legally obliged to respond. Any information you do provide will help us to adapt and monitor our services in the future.
Title
Surname
First Name
Age / 16-24 25-34 35-44 45-54 55-64 65+
Gender / Male Female
Have you ever identified as transgender / For the purpose of this question ‘transgender’ is defined as an individual who lives, or wants to live, full time in the gender opposite to that they were assigned at birth.
Yes No Prefer not to say
Ethnic Origin
(Please tick one) / White Asian Black Chinese Mixed
Other Please specify:
Religion or Belief
(Please tick one) / No Religion or Belief
Christian
Jewish
Other / Baha’i
Hindu
Muslim
Prefer not to say / Buddhist
Jain
Sikh
Sexual Orientation
(Please tick one) / Bisexual
Lesbian / Heterosexual
Prefer not to say / Gay
Disability (Please tick one)
Do you consider yourself to have a disability within the meaning of the Equality Act 2010?
The Equality Act 2010 defines a disabled person as someone who has a physical or mental impairment, which has a substantial and adverse long-term effect on his or her ability to carry out normal day to day activities. Conditions may include, for example, severe depression, dyslexia, diabetes, epilepsy and arthritis
All applicants who have a disability and meet the minimum criteria for the post will be offered an interview in line with the Isle of Anglesey County Council’s commitment to providing opportunities for people with a disability.
Yes No Prefer not to say
If yes, please describe the nature of your disability:
Dyslexia
Blind / Partially sighted
Deaf / Have a hearing impairment
An unseen disability e.g. diabetes, epilepsy, asthma
A disability not listed above / Wheelchair user / Have mobility difficulties
Personal care support
Mental health difficulties
Multiple disabilities
This information is provided for monitoring purposes only - if you need any reasonable adjustments you should arrange these separately.