The Royal National College for the Blind

The Royal National College for the Blind

Venns Lane, Hereford, HR1 1DT

Tel: 01432 265725

Fax: 01432 842979

Minicom: 01432 276532

Email:

Application for Employment

All information will be treated as confidential.

Please complete this form clearly and fully in black ink or typescript.

CVs will not be accepted in place of completing all or parts of this application form.

Application for the Post of:
Personal Details
Title:
Surname:
Forename(s):
Known as (if different from above):
Address:
Postcode:
Home telephone number:
Mobile telephone number:
Daytime telephone number:
Email address:
Are you related in any way to an existing employee or Governor of RNC?
If so, please state name and relationship:
This is to ensure that, as appropriate, the individuals involved are protected from allegations such as propriety, bias, or conflict of interest whether during the selection process, or on any subsequent appointment.
As a registered Disability Confident Committed employer we are committed to offering an interview to applicants with disabilities if they meet the minimum criteria for the job.
As we are registered as a Disability Confident Committed employer do you qualify for a guaranteed interview? /  Yes /  No
Current or most recent employment
Name, address, telephone number of employer, and nature of business:
Dates employed (from – to):
Position held:
Current salary, and any benefits:
Notice required:
Reason for leaving, or intending or leave:
Brief description of duties/responsibilities and key achievements:
Previous employment
Positions should be listed in date order, including the month and year, with the most recent first.
You should account for any gaps in your employment history (subject to the provisions relating to disclosure under the Rehabilitation of Offenders Act 1974).
Include any part-time or holiday jobs, or voluntary roles.
Please note previous employers may be approached by the College to verify employment history.
Successful applicants will be required to account for any gaps in employment history.
Name and address of employer, and nature of business:
Dates employed (from – to):
Position held:
Salary:
Reason for leaving:
Previous employment history continued...
Name and address of employer, and nature of business:
Dates employed (from – to):
Position held:
Salary:
Reason for leaving:
Name and address of employer, and nature of business:
Dates employed (from – to):
Position held:
Salary:
Reason for leaving:
Name and address of employer, and nature of business:
Dates employed (from – to):
Position held:
Salary:
Reason for leaving:
Name and address of employer, and nature of business:
Dates employed (from – to):
Position held:
Salary:
Reason for leaving:
Continue on a separate sheet if necessary, ensuring you cover your full employment period
Qualifications
Place of study / Qualification / Grade / Date achieved
Continue on a separate sheet if necessary
Professional training courses
Please detail here any professional development you have undertaken which is relevant to the role you are applying for
Training attended / Training provider / Duration / Dates attended
Professional Memberships (e.g. IfL, CIPD)
Name of Professional Body / Type of Membership / Membership Number
Additional Skills
Are you able to use Braille?
Are you able to use British Sign Language?
Languages (indicating fluency):
Supporting Statement on skills, knowledge and experience
Please state why you are applying for this post. Indicate past achievements, experience and personal qualities relevant to your application, and state what contribution you would expect to make in this post.
Please refer to the job description, person specification and application guidance when completing this section.
Continue on a separate sheet if necessary, but please do not exceed more than one additional side of A4.
References
Please provide details of two referees who are in a position to provide relevant comment on your work performance, one of which must be your current or most recent employer.
Both referees will be contacted before interview unless otherwise requested.
If you have just completed full-time education, the details of the Head/Principal and/or Teacher should be provided. If you have neither worked nor studied recently, please provide two independent character referees outside your family, and not normally RNC employees.
Referee 1 – Current or most recent employer
Name:
Position:
Business address:
Email address:
Telephone no.:
Can we contact this referee without further reference to you?
Referee 2 – previous employer
Name:
Position:
Business address:
Email address:
Telephone no.:
Can we contact this referee without further reference to you?
Additional Essential Information
Are there any dates you will be unavailable for interview?
Do you have a legal right to work in the UK?
If yes, are there conditions attached – e.g. start or finish dates?
If no, what type of permit do you require?
You are not required at this stage to disclose any spent convictions. However, every successful applicant will be subject to an Enhanced Disclosure from the Disclosure and Barring Service (DBS). This check will include details of cautions, reprimands or warnings as well as convictions and non-conviction information.
Any job offer will be dependent upon a satisfactory outcome, although having a criminal record will not necessarily bar you from employment with us.
Do you have a criminal record?
Declaration
I declare that the information I am giving in this application is accurate and true. I understand that providing misleading or false information may disqualify me from appointment or may result in my dismissal.
I consent to the processing by means of a computer database or otherwise any information I provide RNCB for the purpose of employment, in accordance with Data Protection Act 1998.
Applicant’s signature:
Date:

Diversity Monitoring Form

As an equal opportunities employer the Royal National College for the Blind welcomes applications from people in every part of the community. We are committed to promoting a diverse workforce and to active policies which eliminate unfair discrimination.

Your responses to the questions below will provide statistical information which we can use in order to ensure our policies are being properly implemented and that our services are accessible to all.

Your responses will be treated and held in strict confidence and will not be used to identify you. The information you provide will not affect your application, and your responses will not be known by the selection panel. This form will be separated from your application.

Data Protection Act 1998

The data collected in this form will only be used for the purpose of statistical monitoring. This information will only be retained for as long as is considered necessary for monitoring purposes and then it will be securely destroyed. At all times it will be kept in accordance with this Act.

We thank you for your co-operation in completing this form.

Job details
Post applied for:
Where did you hear about this vacancy?
Personal details
Surname:
Forename(s):
Title: Mr/ Mrs/ Miss/ Ms/ Dr/ other
Nationality:
Place of birth:
National Insurance Number:
Do you require a work permit to work in the UK?
Gender (please cross one box only):
Male / Female / Prefer not to say
Is your gender the gender you were assigned at birth (please cross one box only):
Yes / No / Prefer not to say
Date of birth:
Age (please cross one box only):
Under 25 / 25 – 34 / 35 – 44 / 45 – 54 / 55 – 64 / 65+
Disability
Definition of disability: the Disability Discrimination Act defines a disability as a physical or mental impairment which has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities.
Do you consider yourself to have a disability (please cross one box only):
Yes / No / Prefer not to say
If yes, please indicate the nature of the disability (please cross all boxes that apply):
Visual impairment
Physical impairment
Hearing impairment
Learning disability or difficulty
Mental health condition
Chronic long-term illness (e.g. MS, cancer)
Other (please specify)
Ethnicity (please cross one box only):
White – British
White – Irish
White – other European
White – other
Asian or Asian British – Bangladeshi
Asian or Asian British – Indian
Asian or Asian British – Pakistani
Asian or Asian British – other
Black or Black British – Caribbean
Black or Black British – African
Black or Black British – Other
Mixed – White and Asian
Mixed – White and Black African
Mixed – White and Black Caribbean
Chinese
Other (please specify)
Prefer not to say
Sexuality
Which term would best describe your sexuality? (Please cross one box only)
Lesbian / Gay / Bi-sexual / Heterosexual / Prefer not to say
Religion or belief (please cross one box only):
Atheism / Jainism
Buddhism / Judaism
Christianity / Sikhism
Hinduism / Other
Islam / Prefer not to say