APPLICATION FOR EMPLOYMENT
CONFIDENTIAL
POST: / Regional Development Manager - North
1. Personal details
Surname: / Mr/Mrs/Miss/Ms/Dr.
First Name(s):
Home Address:
Postcode:
Telephone No. / Home: / Work:
Email: / Fax:
The work of Lead Scotland is governed by an equality and diversity policy which aims to prevent discrimination particularly on the grounds of disability, sex, marital status, race, religion, sexuality or responsibility for dependants. All Lead staff have responsibility for ensuring compliance with this policy.
Lead will interview all disabled applicants who meet the essential criteria for a job vacancy and consider them on their abilities.
Do you consider yourself to be disabled? YES NO
If you think it appropriate, please give details and indicate any particular arrangements that would be helpful at the interview stage.
Any assistance required to fulfill the mobility requirement of the post can be discussed at the interview stage.
2. Education
School(s): / Qualifications obtained / Year(s)
Further/Higher Education / Qualifications obtained / Year(s)
Other training/professional qualifications relevant to this application (continue on separate sheet if necessary:
Name of Course / Provided by / Duration
Details of any training you might need, if appointed to the post:
3. Name & address of current employer
4. Present position, duties & date of appointment
5. Present salary & benefits
6. Period of notice due
7. Particulars of previous employment (paid or voluntary)
(State names of employers, type of work undertaken, dates employed and reasons for leaving, giving most recent employer first)
8. Referees
Please give the names and addresses of two persons who have direct experience of you at work or in education/training. Your current or most recent employer will always be contacted for a reference. Please indicate below if your referees can be contacted prior to interview.
1.
Name: / Status:
Address: / Tel. No:
Email:
Contact prior to interview (Y/N):
2.
Name: / Status:
Address: / Tel. No:
Email:
Contact prior to interview (Y/N):
9. Statement in support of your application
Please state concisely why you are applying for this post, and clearly indicate the relevant qualities, and experience you would bring - having regard to the essential criteria for the post.
Where did you learn of this post?
Signature of applicant / Date:
Please return this form to: / or post to
Personnel
Lead Scotland, Edinburgh Napier University, Room 0/5, 14 Colinton Road, Edinburgh, EH10 5DT
Deadline for submission: / 5pm on 13th March 2017
Completion of this form rather than submission of a CV is required. Thank you.


EQUALITY MONITORING FORM

Equal and Diversity Policy: The work of Lead Scotland is governed by an Equality and Diversity Policy; reviewed and approved by the Board of Directors.

Monitoring the Policy: Lead would be grateful for your co-operation in completing the sections below to help ensure that our equality and diversity policy is being carried out. Completion of the form is voluntary and it will be separated from the application form on receipt. If you do not complete this form it will not alter the treatment of your application. The information you supply will be treated in the strictest confidence and, if you choose to include your name, you will not be personally identified in any statistics.

GENDER (please tick) Female Male Transgender

Are you disabled? YES/NO

Please give details if you consider this appropriate

ETHNIC ORIGIN: please tick your ethnic group (categories used in the 2011 Census)

White / Mixed or multiple ethnic groups / Asian, Asian Scottish or Asian British / African, Carribean or Black
Scottish / Any mixed or multiple groups, please write / Pakistani, Pakistani Scottish or Pakistani British / African, African Scottish or African British
English / Indian, Indian Scottish or Indian British / Carribean, Carribean Scottish or Carribean British
Welsh / Other Ethnic Group / Bangladeshi, Bangladeshi Scottish or Bangladeshi British / Black, Black Scottish, or Black British
Northern Irish / Arab / Chinese, Chinese Scottish/Chinese British / Other please write in
British / Other please write in / Other please write in
Irish
Gypsy Traveller
Polish
Any other white ethnic origin group:

AGE - please tick

Up to 24 25-49 50-64 65 upwards

How did you find out about this post?: ______

Post: ______Name: ______