Application for Employment

Please fill in this form, writing clearly and completing all sections in full and post to

HR & Recruitment, The EBP, Welton House, Limekiln Way, Lincoln LN2 4WH

or email the application form to

Application for the post of:
Title / First name(s) / Surname
Former Names (if applicable) / National Insurance Number

Contact Details

/ Mobile Number:
Landline Number:
Work Number:
Email Address:
Your preferred method of contact:
Home address (including postcode)
Equal Opportunities
The EBP is an Equal Opportunities Employer. We are committed to ensuring all recruitment processes are non-discriminatory and that no potential or current employee is treated less favourably on the ground of sex, marital status, sexual orientation, race, nationality, ethnic or national origin, colour, disability, religion / belief or age. To assist us in monitoring our performance in relation to equal opportunities you are asked to provide the following information.
Completion is optional and is used for recruitment statistical monitoring purposes only.
Date of Birth / Age
Gender / Religion or Belief
Are you eligible to work in the UK? / Ethnic Origin
Do you consider yourself to have a disability? If yes please add details. / Marital Status
How did you learn about this vacancy?
Do you hold a current and valid driving licence?
Yes □ No □
/ Do you have a car available for work?
Yes □ No □ / Do you have car insurance for business purposes?
Yes □ No □
Details of driving licences held (For example, provisional, full or HGV etc.):
Details of previous motoring offences:
Do you hold a current DBS check and/or DBS Update Service check? / Yes □ No □
If yes please give details of:
Date of issue:
Issue Number:
The EBP is an equal opportunities employer and welcomes all applicants. Do you have any special requirements relating to interview arrangements? / Yes □ No □
If yes please give details of:
Have you been convicted of any criminal offences, which are not yet spent under the Rehabilitation of Offenders Act 1974 / Yes □ No □
If yes, please provide details. If necessary continue on separate sheet.
If applying for a position which involves working with children ALL convictions / cautions must be declared (regardless of whether deemed as spent). Please provide details, if necessary continue on separate sheet. The Job Description will confirm whether a role involves working with children, and whether a DBS check is required. Further details can be obtained from The EBP HR department.
………………………………………………………………………………………………………………………
Failure to declare convictions / cautions may result in withdrawal of a job offer. All such information will be treated in the strictest confidence and only taken into consideration if strictly relevant. For positions that involve working with children, the successful candidate will be required to undergo an Enhanced Disclosure and Barring Service (DBS) check before employment can be confirmed. Further details can be obtained from The EBP HR department.
Allegations and disciplinary action in relation to working with children
If you have been subject to disciplinary action or if there have been allegations made in relation to your working with children, this must be disclosed. Any information about past disciplinary action or allegations will be considered in the circumstances of the individual case. All such information will be treated in the strictest confidence and only taken into consideration if strictly relevant.
Have you been the subject of an allegation(s) or disciplinary action in relation to working with children?
Yes □ No □
If yes, please provide details relating to the nature of the allegation(s) and the date and / or the disciplinary action and the date. If necessary continue on separate sheet.
……………………………………………………………………………………………………………………………
Referees
For Safeguarding purposes we must receive a reference from your current or most recent employer. If you have previously worked with children but not in your last role, than the employer with which you last worked with children will also be required to provide a reference.
Please tick here if you are happy for us to take up references prior to interview, if you are shortlisted. Otherwise we will only contact your referees if you are offered a post.
Current or most recent employer / Other (not a relative or friend)
Name:
Position:
Company:
Address:
Phone/Mobile:
Email: / Name:
Position:
Company:
Address:
Phone/Mobile:
Email:
Education History (Including further or higher education)
Educational Establishment / Dates: you MUST include month as well as year:
e.g. Jan 2012 – Feb 2013 / Course / Subjects / Qualifications gained
Other training (e.g. Management, In-Service Professional etc.)
College/Institute/
other name / Dates / Subjects studied / Qualifications/level achieved
Member of professional associations
Professional Body / Status of
Membership / Membership by exam?
Yes/No / Date acquired
Employment History
Appointments in reverse order (Dates should indicate day, month and year)
Present (or last) employer / Dates of employment
(Start/End) / Job title / Grade / gross salary
Main duties:
Full time / Part time / Period of notice required
Reason for leaving
Previous employer / Dates of employment
(Start/End) / Job title / Grade / gross salary
Main duties:
Full time / Part time / Period of notice required
Reason for leaving
Previous employment: please complete employment history in full, including all part time positions and any employment that you have been in at the same time. It is essential that a complete history is provided, including any periods of unemployment. This information is for inspection purposes relating to Safeguarding Children Act. Please use a continuation sheet if required.
Employer / Dates of employment
(Start/End) / Job title / Reason for leaving
Personal Statement
Please expand upon the personal qualities you possess and any relevant experience gained from your current or previous employment which may demonstrate your suitability and support your application for this post.
Please continue overleaf if necessary
For the purposes of the Data Protection Act 1998, I consent to the information contained in this form and any information received by or on behalf of the Lincolnshire & Rutland Education Business Partnership relating to the subject matter of this form, being processed by them in administering the recruitment process.
I declare that all the information on this form is true and correct. I understand that any false statement or omission will normally lead to my being dismissed if appointed to this post.
Signature______Date______
All candidates applying for employment via email will be required to sign and date this form if invited to attend an interview.
To be completed by HR:
Declared disability? / Yes □ No □
If yes does this applicant meet the minimum essential criteria? / Yes □ No □
Shortlisted / Offered
Continuation Sheet

EBP Application for Employment Form November 2016