Access Recognition and Licensing Committee application form 2017

Access Recognition and LicensingCommittee application form

Please note that boxes will grow as you type into them.

Personal details

Post applied for / Membership of the Access Recognition and Licensing Committee
How did you learn of the vacancy? (please specify name of publication or website)

All applicants please fill in this section:

Full name
Title (Mrs, Mr, Miss, other)
Address
Postcode
Work telephone number
(if applicable)
May we contact you at work? / Yes/No
Mobile telephone number
Email address

Please fill in this section if you have links with an Access Validating Agency (AVA):

Name and address of institution
Name of AVA
Role within the AVA, eg committee member, course provider

Supporting statement

Please provide us with further relevant information in support of your application, referring to the information in the candidate pack.Please provide specific examples outlining why you think you are suitable for this role, including the skills and experience that you have. Maximum one page.

Please confirm your availability for the following dates

Members of the Access Recognition and Licensing Committee will need to attend a minimum ofthreemeetings.

Wednesday 15 November 2017 / Yes/No
Wednesday 5 February 2018 / Yes/No
Wednesday 18 April 2018 / Yes/No
Wednesday 18 July 2018 / Yes/No

Please ensure that you have fully completed all points on this application form.

Declaration

I declare that the information given on this form is, to the best of my knowledge, true and complete.

I understand that any false statements may be sufficient cause for my rejection or,
if appointed, dismissal.

Signature
(e-signature isacceptable)
Date

Confidential

Equal opportunities monitoring form

Policy

QAA is committed to the principle of equal opportunities. The aim of this policy is to ensure that all people engaged on contracts for services are recruited according to their ability to fulfil the requirements of their role. There will be no discrimination on the grounds of, for example, race, colour, creed, ethnic or national origins, nationality, disability, age, gender, sexual orientation, marital status or family responsibility in any matter relating to your application.

Monitoring

QAA has adopted the recommendations in the Codes of Practice published by the Equality and Human Rights Commission that organisations should regularly monitor the effects of decisions to assess whether equality of opportunity is being achieved. For this purpose you are asked to complete the form below. The information will be treated as strictly confidential and used anonymously, for statistical purposes only. This form will be removed from your application prior to consideration.

Date of birth:

I would describe my ethnic origin as: (please put a cross in the appropriate box)

White - British / Asian/Asian British - Indian
White – Irish / Asian/Asian British - Pakistani
White – other / Asian/Asian British - other
Mixed - white/black African / Black/black British - Caribbean
Mixed - white/black Caribbean / Black/black British - African
Mixed - white/Asian / Black/black British - other
Mixed – other / Other ethnic group
Chinese

I am: (please put a cross in the appropriate box)

Male / Female

Are you disabled within the meaning of the Equality Act 2010? (please put a cross in the appropriate box)

Yes / No

Additional information

General information

Do you need approvalthroughthe requirements of the UK Border Agency to work in the UK?(delete as appropriate) / Yes/No

Convictions

Have you ever been convicted of a criminal offence? (declarations subject to the Rehabilitation of Offenders Act 1974)(delete as appropriate) / Yes/No
If yes, please give details.

Please help us to ensure the effectiveness of our Equal Opportunity policy by completing
this form.

Please return this form to.

Alternatively, post to:Ann-Marie Karadia,Quality Assurance Agency for Higher Education, Southgate House, Southgate Street, Gloucester GL1 1UB.

The deadline for all applications, via email or post, is noon 8 September 2017.

Applications submitted after the deadline will not be accepted.

© The Quality Assurance Agency for Higher Education 2017

Registered charity numbers 1062746 and SC037786

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