Recruitment Monitoring Questionnaire
Every Child is committed to equality of opportunity in the recruitment, retention and development of its workforce in order to ensure it reflects and attracts talented people from the diverse society within which it operates. The purpose of this equality monitoring form is to ensure that our policies and procedures do not inadvertently discriminate on any specific group, and are fair and transparent.
We would like to assure you that any information you provide in this form will be kept confidential and will be processed in line with the requirements of the Data Protection Act, 1998. Your data will therefore be only used for statistical purposes. No information will be published or used in any way which allows any individual to be identified.
Whilst completing this form is not a mandatory requirement, your co-operation in providing us with accurate data would greatly assist us to promote equality and diversity within our organisation.
Position Applied for: / Senior Supporter Care OfficerFirst Name:
Surname:
Date of Birth:
Disability
Under the Equality Act 2010 disability is defined as any physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.
Do you consider yourself to have a disability as defined by the Equality Act 2010?
YesNo Prefer not to say
I would describe myself as having the following:
Gender:
MaleFemale
Ethnic origin: (Please tick)
White / Mixed heritage / Asian / Black or Black British / Chinese or otherBritish / White & Black Caribbean / Indian / Caribbean / Chinese
Irish / White & Black African / Pakistani / African / Other (please state)
Other / White & Asian / Bangladeshi / Other (please state)
Other (please state) / Other (please state)
Where did you see this post advertised? ………………………………………………………
Application Form
Please return completed application form to: PRIVATE & CONFIDENTIAL
Maria Tsang, HR Manager
Post: Regus 5th Floor, 133 Houndsditch, London EC3A 7BX
Email:
Position applied for: / Senior Supporter Care OfficerClosing date: / Monday 18th January 2016
1st Interview: / 21st & 22nd January 2016
2nd Interview: / TBC
Personal Details
Title:First Name:
Surname:
Address:
Email address:
Contact phone number:
Holiday arrangements planned:
Do you need permission to work in the UK? If yes which visa do you hold?
The first interviews are due to be held on Thursday 21st and Friday 22nd January 2016. Are you able to attend during this week?
Where did you hear about this vacancy?
Education History
School
Name of SchoolDates attended
Qualifications and grades
College/University
Name of College/UniversityDates attended
Qualifications and grades
Other training
Name of Course/TrainingDates attended
Qualifications
Employment History
(Starting with most recent first)
Name of Employer:Job Title:
Dates position held:
Main responsibilities:
Reason for Leaving:
Name of Employer:
Job Title:
Dates position held:
Main responsibilities:
Reason for Leaving:
Name of Employer:
Job Title:
Dates position held:
Main responsibilities:
Reason for Leaving:
(Please continue on another sheet if appropriate)
Supporting Information
Please tell us how you think your skills and experience meet the criteria outlined in the job description and person specification. You should provide enough information to fill an A4 sheet.
Have you applied to work at EveryChild before?(If yes, please state which job applied for)
Current/Last salary
Do you have pending or have you ever been convicted of a criminal offence (other than minor driving offences) which is not a spent conviction under the Rehabilitation of Offenders Legislation?
If yes, please give further information (use separate sheet if necessary):
EveryChild from time to time requires its employees to work overtime which is unpaid. Would you be able to work overtime? Never/Occasionally/Frequently
EveryChild’s offices are at 133 Houndsditch, London, EC3A 7BX. Do you expect to travel there without difficulty?
EveryChild’s hours are 9.30am to 5.30pm, Monday to Friday. Will you be able to attend regularly? If no, please state reason
Supplementary Information
As a matter of good practice for organisations that work with children, all staff and volunteers at EveryChild are required to consent to a background check through the Disclosure service of the Criminal Records Bureau.
Please delete as appropriate:
I give consent to a background check/I do not give consent to a background check.
References
If we offer you the post we will want to take up references immediately after the offer is made, but not before. Any offer of employment will be subject to our receiving satisfactory references. Please state the name of at least two referees below, one of who must be your present or immediate past employer.
- Name:
Company:
Job Title:
Contact details:
Relationship to you:
- Name:
Company:
Job Title:
Contact details:
Relationship to you:
Declaration of ApplicantI confirm that the above information is correct. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable for dismissal
Signature: ______Date: ______
Data Protection: Your signature on this form authorises the Personnel Administrator to process this personal data and sensitive personal data for the purposes of your application for employment with EveryChild. It will be treated and filed as confidential information. It will not be made available to a third party without written permission from the applicant. If you are appointed to the post your application form will be kept for the duration of your employment. If you are not appointed to the post, the form will be kept for 6 months and then destroyed. I understand that the personal data which I have provided on this form may be stored in paper or electronic form in accordance with EveryChild’s policy on Data Protection and with the provisions of the Data Protection Act 1998.
PLEASE NOTE THAT EVERYCHILD HAS A “NO SMOKING” POLICY AND SMOKING IS NOT PERMITTED ON THE PREMISES OF ITS LONDON OFFICE.