IMPORTANT

Please complete this form in BLACK, handwritten, on-line or type. Please complete every section.
This form is the only acceptable format for application. ‘CVs’ and other documents will NOT be considered unless specifically requested.
The College operates an equal opportunity policy to ensure that all people who apply for posts with the College receive equal treatment in employment, regardless of their age, gender, marital status, disability, sexual orientation, social background, race, religion, ethnic or national origin. Applicants are particularly welcome from minority communities, women and disabled people. The College has a strong commitment to the safeguarding of all its learners and staff are required to share this commitment.

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NOTE TO APPLICANTS

Data Protection – this application will be used for management and administration purposes as well as monitoring the application of the College’s Equal Opportunities policy in employment. By providing any information on this form you give your consent to allow this information to be processed.
If you have any difficulty in completing this application form because of language problems, literacy or disablement, please contact Human Resources about special arrangements.
1.  VACANCY DETAILS
Application for the position of:
Salary:
Closing Date:
2.  PERSONAL DETAILS
Title: / First Name(s): / Surname/ Family Name:
Address:
Postcode:
Daytime Tel Number: / Evening Tel Number: / Mobile Tel Number:
NB: calls to work numbers will be made discreetly and only made if permission is given by yourself. Please tick if you agree:
E-mail address:
3.  PRESENT EMPLOYER (please state if unemployed)
Name:
Address:
Postcode:
Job held:
Brief description of duties, including responsibilities and achievements if relevant:
Date employed from: / Current salary: / Notice required to terminate:
4.  EMPLOYMENT RECORD
Give details of previous employment, including details of dates and brief description of duties, starting with most recent employment.
Employer’s Name and Address / Dates From – To / Job Held and Brief Description of Duties / Reason for Leaving
5.  EDUCATION AND TRAINING
Please give details about any education and training received in this country or abroad and qualifications obtained, with dates.
Establishment Attended / Course Attended / FT/PT / Qualification Obtained (with grades where applicable) / Dates
6.  SUPPORTING STATEMENT
Please give details of previous experience and any other information that you consider relevant to the post as described on the job description/person specification (use continuation sheet if necessary).
7.  REFEREES
Please nominate two referees. One of your referees MUST be your most recent employer. If you have not previously been in employment two character references will suffice. If these people know you by a different name from the one given at the beginning of the application, please give that name
Referee 1: / Referee 2:
Name: / Name:
Post Held: / Post Held:
Relationship to Referee: / Relationship to Referee:
Company Name & Address: / Company Name & Address:
Telephone Number: / Telephone Number:
Email Address: / Email Address:
If chosen for interview, do you object to your referees being contacted before an offer of employment is made?
Referee 1: / Yes: / No: / Referee 2: / Yes: / No:
8.  ADDITIONAL QUESTIONS
Do you own or have access to a motor vehicle? / Yes / No / Do you hold a current driving licence / Yes / No
Do you have any driving endorsements? / Yes / No / If YES give details:
Are you currently eligible for employment in the UK? / Yes: / No:
Please state below what documentation you can provide in order to demonstrate this (eg British passport/birth certificate/European Economic Area identity card/travel document, showing an authorisation to reside and work in the UK etc)
Please read the enclosed notice to applicants regarding convictions before answering the next question.
Have you ever been convicted, warned or cautioned? (you must answer) / Yes / No
Do you know or do you have any relationships with any member of Stephenson College staff or governors? / Yes: / No:
If YES please state name and job title:
Where did you learn of this vacancy?

Applicants called to interview must bring proof of identity, qualifications and any professional registration.

9.  STATEMENT
To the best of my knowledge and belief, the information contained in this form is accurate. I understand that any false declaration or misleading statement or any significant omission may disqualify me from employment and render me liable to dismissal. I understand the job offer is subject to satisfactory references and satisfactory Enhanced DBS Clearance. I accept that the College will take reasonable steps to verify the accuracy of the information I have provided. Candidates returning application by e-mail will be asked to sign this page if invited for an interview
Signature: / Date:
POST INFORMATION
Application for the post of:

DISCLOSURE OF CRIMINAL CONVICTIONS

As Stephenson College meets the requirements in respect of exemption under the Rehabilitation of Offenders Act 1974, all applicants who are offered employment will be subject to a Disclosure and Barring Service (DBS) check as a condition of the appointment. This includes a check of the DBS Barred Lists. Therefore, all applicants must complete and date one of the boxes either A or B below. Applicants must complete and date box C.

Please read the guidance notes carefully before completing this form

We operate checking procedures in accordance with the Home Office Circular 86/44, Circular 4/86 and the Disclosure procedures detailed in the Protection of Freedom Act 2012. If you are selected for appointment, you will be subject to these procedures (see guidance notes for more information).
Explanatory Notes
·  The post you are applying for is exempt from Section 4b of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (exemptions) Order 1975 & 1986 and as such successful candidates will be subject to an enhanced DBS check. This will reveal certain cautions and convictions; even offences considered ‘spent’ and which you may previously have been advised would not appear after a given number of years.
·  If you give any information which you know is false or if you withhold any relevant information, this may lead to your application being rejected or if you have already been appointed, to your dismissal.
A)  I declare that I have no criminal convictions, cautions or bind-over orders to disclose:
Name:
Signed: Date:
Please tick the box if you are applying via email
Candidates returning application by e-mail will be asked to sign this page if invited for an interview
B) I declare that I have criminal convictions, cautions or bind-over orders to disclose :
Name
Signed: Date:
Please tick the box if you are applying via email
Candidates returning application by e-mail will be asked to sign this page if invited for an interview
C) I declare that I am not listed on the DBS Barred Lists and I understand that it is a criminal offence to knowingly withhold such information
Name
Signed: Date:
Please tick the box if you are applying via email
Candidates returning application by e-mail will be asked to sign this page if invited for an interview
POST:
PERSONAL INFORMATION
Full Name: / Title: Miss/Ms/Mrs/Mr or Other:
Address:
Postcode:
Date of Birth: / Age:
Gender: / Male: / Female: / Marital Status:
Do you wish to be considered as a person having a disability? / Yes: / No:
If YES, please state what additional or modified equipment/materials you require for the post:
ETHNIC ORIGIN (please tick)
WHITE
/ British: / Irish: / Other White Background (please state):
ASIAN or ASIAN BRITISH / Indian: / Pakistani: / Bangladeshi: / Other Asian Background (please state):
BLACK or BLACK BRITISH / Caribbean: / African: / Other Black Background (please state):
MIXED / White & Black Caribbean: / White & Black African: / White & Asian: / Other Mixed Background (please state):
CHINESE or ANY OTHER ETHNIC GROUP / Chinese: / Any Other (please state):
NATIONALITY (please state):
PLEASE STATE WHERE YOU LEARNED OF THIS VACANCY:

COMPLETED APPLICATION FORM TO BE RETURNED TO HUMAN RESOURCES AT THE ADDRESS BELOW

I agree to the use of this information for monitoring purposes and statistical analysis and returns

Signature: / Date:

Office use only

Interviewed / Appointed
STEPHENSON COLLEGE, Thornborough Road, Coalville, Leicestershire, LE67 3TN

Telephone – 01530 836136

E-mail – Website – www.stephensoncoll.ac.uk