This Form Can Be Downloaded from the College S Web Site ( ). Please Complete All Parts
Section 1 will be detached and kept by the Human Resources Department in the strictest of confidence.
CLOSING DATE
APPLICATION NO:
(office use only)
This form can be downloaded from the College’s web site (). Please complete all parts of the application form in full to ensure its consideration in the shortlisting process. CV attachments will not be accepted.
East Riding College is committed to safeguarding and promoting the welfare of children, young people and vulnerable adults and expects all employees and volunteers to share this commitment. The suitability of all prospective employees or volunteers will be assessed during the recruitment process in line with this commitment.
- Personal Details
All the information in this application form will be treated with the strictest of confidence. All parts of the form require completion. This should be done neatly and accurately in black ink or print. You may attach extra sheets where necessary but please ensure your name, post title and the relevant question is put at the top of each extra sheet.
The aim of this section is to collect basic information such as your name and address in addition to personal information in order to allow the College’s Equality Policy to operate effectively. Applicants are considered on suitability regardless of their race, disability, gender, age, sexual orientation, religion and belief, gender reassignment, pregnancy or marital status.
Title: / Surname: / First Name(s):
Address:
Post Code:
Telephone (Home): / Telephone (Mobile):
Telephone (Work): / Can you be contacted at work? YES / NO
Email Address:
NI Number:
Do you hold QTLS/ATLS? YES / NO / IFL Membership No:
Disability
Should you be shortlisted for interview, please contact us if you have any individual needs, e.g. help with access, disabled parking or require emergency evacuation assistance.
Where did you see this post advertised
Section one continued.
Criminal Convictions, Cautions, Reprimands or any other relevant information.
East Riding College is an educational establishment that provides education to children and/or vulnerable adults. Therefore the College needs to assess your suitability for the position you are applying for and is entitled to ask questions about your criminal record. You are required to disclose certain information concerning your criminal cautions and convictions. You must disclose information about spent and unspent criminal convictions (other than a protected conviction) and spent and unspent cautions (other than a protected caution). You are not legally required to disclose information concerning protected cautions and convictions. To determine if your caution or conviction is protected and whether or not you need to disclose it in your application, please refer to the table below.
Aged 18 or over at the time of the offence / Aged under 18 at the time of offence
Protected
Convictions / An adult conviction will be a ‘protected conviction’ and will not need to be disclosed by an applicant if all of the following apply:
- 11 years have elapsed since the date of conviction;
- It is the applicant’s only offence, and
- It did not result in a custodial sentence
If an applicant has more than one offence, then details of all their convictions will need to be disclosed. / A young persons conviction will be a ‘protected conviction’ and will not need to be disclosed by an applicant if all of the following apply:
- Five and a half years have elapsed since the date of conviction;
- It is the person’s only offence, and
- It did not result in a custodial sentence.
If an applicant has more than one offence, then details of all their convictions will always be included.
Protected
Cautions / An adult caution will be a ‘protected caution’ and will not need to be disclosed by an applicant if all of the following apply:
- Six years have elapsed since the date the caution was issued, and
- It does not appear on the list of specified offences.
- Two years have elapsed since the date the caution was issued, and
- It does not appear on the list of specified offences.
The suitability for employment of a person with a criminal record will vary, depending on the nature of the job and the details and circumstances of any convictions. A risk assessment for the particular post will be assessed against the applicant’s skills, experience and conviction circumstances.
No ex-offender with a conviction for a sex offence will be employed at the College.
Details of spent and unspent criminal convictions and/or cautions (other than protected convictions/cautions including date of and place of conviction:
As the post you are applying for involves working with/in close proximity to children, young people or vulnerable adults, references will be sought and enquiries made, including a Disclosure and Barring Service (DBS) check, before an appointment is made.
When enquiries are made, it is important that identity is clear. If you have previously been known by another name (e.g. maiden name, former marriage, change by deed poll etc), please state here with dates of use of former names:
- Education
Please provide details of your formal qualifications and training so that we can compare these with the requirements detailed in the person specification. Please state the subjects associated with your qualifications in the three sections below. If successful, you will be required to produce certificates in respect of your qualifications. Please give details in chronological order.
Name & Address of
College, University, Provider / Qualifications obtained/Level
of membership / Grade (inc GCSE/GCE grades) / Year
Taken
Secondary School Education
Post 16 Education (School or Further Education)
Higher Education and Professional Qualification
Training
Membership of Professional Bodies
Other
- Current or Last Employer
The purpose of this section is to collect some general information about your most recent employment and your main duties, responsibilities and experience gained that are relevant to the person specification.
Post Title: / Full Time / Part Time
Name and Address of Employer:
Basic Salary: / Per: Annum / week / hour / Allowances: / Grade/Scale:
Start Date: / Contract End
Date (if app): / Notice Required:
Reason for leaving this post:
Main duties, responsibilities and experience relevant to the job description and the person specification:
- Previous employment (most recent first).
List here your full employment history since leaving secondary education. Please leave no unexplained gaps - include periods of unemployment, study, voluntary work, raising a family or multiple employment. It is important that reasons for leaving are given fully.
Name of Employer: / Dates Employed: / Employment Status:
Experience / Role / Duties / Responsibilities:
Reason for Leaving:
Name of Employer: / Dates Employed: / Employment Status:
Experience / Role / Duties / Responsibilities:
Reason for Leaving:
Name of Employer: / Dates Employed: / Employment Status:
Experience / Role / Duties / Responsibilities:
Reason for Leaving:
Name of Employer: / Dates Employed: / Employment Status:
Experience / Role / Duties / Responsibilities:
Reason for Leaving:
Name of Employer: / Dates Employed: / Employment Status:
Experience / Role / Duties / Responsibilities:
Reason for Leaving:
Please use additional sheet if required.
- Supplementary Information
Please give any additional information which you consider may be useful in forming a judgement of your suitability for this post. If you are applying for a teaching post, please indicate any school/college activities, societies or youth activities in which you may be interested.
This is an important part of your application. You should make statements that demonstrate how your qualifications and experience match the criteria outlined in the person specification. You may add an additional sheet but this section should be no longer than 2 A4 sides.
For teaching posts only:
Other Subject(s) you are able to teach:
- General Information
Do you have a family or close relationship to an Employee or Governor of this College: YES / NO
If Yes, please state name: / Post Held:
NB Canvassing or failure to disclose may disqualify your application
If successful, when would you be able to commence duties?
What category of driving licence do you hold? (please delete as appropriate)
NONE / MOTORCYCLE / CAR / HGV / PCV / OTHER (please specify)
- References
Please nominate two referees who have consented to provide a reference on your behalf. If you are in or have just completed full time education, one referee should be from your school/college. If in employment, one referee should normally be your current employer. We reserve the right to request a third reference if the post for which you have applied involves working with vulnerable groups and you have been employed in a previous post that included such contact (and which you have not included as one of your two referees). If you are an internal candidate, references will be automatically sought from your line manager or another appropriate member of staff.
Referee 1 / Referee 2
Name / Name
Address / Address
Post Code / Post Code
Email / Email
Position / Relationship / Position / Relationship
- Data Protection
In accordance with the Data Protection Act 1998, I agree to East Riding College processing personal data contained in this application form or other data which the College may obtain from me or other people in respect of this application or in respect of my health and safety whilst on the premises or for any other legitimate reason.
Signed: / Date:
- Declaration
The College reserves the right to verify claims made in this application. Please ensure you have answered all the questions and completed section one of this application.
The information provided in this application is correct to the best of my knowledge and belief.
Signed: / Date:
Please send your completed application form to: or The Human Resources Department, East Riding College, Flemingate Centre, Armstrong Way, Beverley, East Yorkshire, HU17 0GH
Deliberate fraud or deception in respect of this application for employment may amount to a criminal offence. Any employee found to have provided false or misleading information will be summarily dismissed.
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Equality Information
The aim of this section is to collect personal information in order to allow the College’s Equality Policy to operate effectively. Answers to these questions are voluntary. Applicants are considered on suitability regardless of their race, disability, gender, age, sexual orientation, religion and belief, gender reassignment, pregnancy or marital status.Date of Birth:
Age: / Under 25 / 25-34 / 35-44 / 45-54 / 55-64 / 65+
Disability
This information is required to monitor equal opportunities issues in the Further Education sector and supports the College’s Equality Policy. (Please tick the box that applies)
No Known Disability
Two or more impairments and/or disabling medical conditions
A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D
General learning disability (such as Down’s syndrome)
A social/communication impairment such as Asperger’s syndrome/other autistic spectrum disorder
A long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
A mental health condition, such as depression, schizophrenia or anxiety disorder
A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches
Deaf or serious hearing impairment
Blind or a serious visual impairment uncorrected by glasses
Prefer not to say
A disability, impairment or medical condition that is not listed above:
(Please Specify)
Cultural and Ethnic Origin
This information is required to monitor the distribution of ethnic groups amongst Further Education staff and supports the College’s Equality Policy. Please show which group best describes your ethnic origin or descent by ticking one of the following:
Any Other / Mixed – Any Other
Asian/Asian British – Any Other / Mixed – White & Asian
Asian/Asian British – Bangladeshi / Mixed – White & Black African
Asian/Asian British – Indian / Mixed – White & Black Caribbean
Asian/Asian British – Pakistani / White – Any Other
Black/Black British – African / White – British
Black/Black British – Any Other / White – Irish
Black/Black British – Caribbean / White – Other European
Chinese / Prefer not to say
Please State your Nationality:
Do you require to be registered under the Worker Registration Scheme?YES / NO
Religion and Belief
This information is required to monitor equal opportunities issues amongst Further Education staff and supports the College’s Equality Policy. Please tick one of the following to show your religion:
No Religion / Jewish / Spiritual
Buddhist / Muslim / Hindu
Christian / Sikh / Prefer not to say
Any Other religion of belief
Sex / What is your legal sex, i.e. the sex given on your birth certificate?
(Please tick the box that applies)
Male / Female / Prefer not to say
Gender identity / Do you live in a gender different to the one given at birth?
Yes / No / Prefer not to say
Sexual Orientation / Please tick one of the following to show your sexual orientation:
Bisexual / Gay Woman/Lesbian / Other
Gay Man / Heterosexual / Prefer not to say
Pregnancy and Maternity / Are you currently pregnant or have you been pregnant in the last year? (Please tick the box that applies)
Yes / No / Prefer not to say
In the past year, have you taken:
Maternity Leave / Additional Paternity Leave (e.g. more than two weeks) / Adoption Leave
Application Form (June 2016)