Suffolk County Council SCC1 JOB APPLICATION FORM Please return completed applications to: BUNGAY HIGH SCHOOL QUEENS ROAD BUNGAY SUFFOLK NR35 1RW PLEASE READ THE ENCLOSED GUIDANCE NOTES BEFORE COMPLETING THIS FORM Complete all shaded areas in black ink Job title Department Location Personal Details Surname Date of birth (This is requested for administrative purposes only Title (Mr, Mrs, Miss, Ms, Dr) and will not be a factor in the selection procedure) Forenames National Insurance No Address Home tel Work tel County Postcode E-mail address Do you have a current driving licence? Yes No (also see disability/health section below) Please give licence details if the job entails driving public service or large goods vehicles Give details of any penalties on your licence or convictions pending if driving is essential to the job Do you have a disability / long term illness? Yes No (also see disability/health section below) If “yes”, indicate here if you are aware of any adjustments that the County Council could make to help you apply for or carry out the job (see guidance notes) Continue on separate sheet if required Are you applying to do this job on a job-sharing basis? Yes No If “yes”, indicate here if you wish your application to be considered as a joint application with someone else, giving his / her name Educational qualifications and training You may be asked to provide evidence of qualifications obtained Secondary education (CSE, GCE, GCSE, RSA, A Levels etc) Schools From To Exam Result(s) (subject, level & grade) Date FURTHER AND HIGHER EDUCATION (Degree, Diploma, BTEC, City & Guilds, NVQ etc) Institution Dates Full Qualification Subject Pass Level or PT or Grade Other relevant qualifications including membership of professional bodies Relevant training and personal development (State who provided training, duration and dates) Examples could include: short courses, skills training, external awards/activities, etc. Current / latest employment Name and address of current / most recent Job title employer Current / latest salary and any benefits Weekly hours Date started in post Date of leaving (if relevant) Notice required Reason for leaving Main duties / responsibilities / achievements References Normally, references will be requested for all candidates invited for interview, unless you ask us not to by ticking the “no” boxes below. This will not affect our decision to invite you for interview. However, references will need to be taken up if you are successful. The County Council operates a policy of open references. This means that the person who is the subject of a reference may read it, upon request. Please give the names and addresses of who people who would be willing to supply a reference about you, including your most recent employer (or teacher / tutor, where appropriate), who have known you during the past three years, if that is possible. Please also state in what capacity they know you. Name Name Address Address Tel no Tel no E-mail address E-mail address Relationship Relationship Organisation (if applicable) Organisation (if applicable) May we contact them if we decide to invite you for interview? Yes No Yes No The information requested on this page may be provided on a separate sheet if preferred Work and other relevant experience Please list below a complete record of other employments and activities, either paid or unpaid. These should be in date order, starting with the most recent. Dates Name of organisation and Job title / role with brief indication of Reason for From To nature of business main duties and responsibilities leaving mm mm yy yy The information requested on this page may be provided on a separate sheet if preferred How you meet the selection criteria It is important that you provide evidence in this section of how you meet the criteria set out in the details provided. Tell us about things you were responsible for and what you achieved. Include examples from paid or unpaid work or other activities you have undertaken that are relevant to the job you are applying for. Also include here information about why you want the job and anything else you wish to say. Continue on separate sheet if required You must complete all sections on this page Canvassing of county councillors, school governors or senior employees Canvassing of county councillors, school governors or employees of the County Council, by or on behalf of yourself, is strictly forbidden and may invalidate your application. Indicate here if you are related to any county councillor, school governor or senior employee of the County Council, giving their name (and department, if known, where relevant). Please state NONE if appropriate. Criminal convictions Please give details of criminal convictions below. Unless stated otherwise, you do not need to declare convictions which are “spent”, as defined by the Rehabilitation of Offenders Act 1974 and subsequent regulations. However, if you are applying for a job supervising, caring for or otherwise connected with people from the following list, you must always declare any convictions and/or cautions for criminal offences, even where they are “spent”. For these purposes, this includes working with children, young and older people, those who are dependent on alcohol or drugs, and those with mental or physical disabilities, illness, injury or deformity, including people who are blind, deaf or without speech. CRB checks are mandatory for all posts in schools. Details of criminal convictions Please state NONE if appropriate. Entitlement to work in the UK To comply with the Asylum and Immigration Act 1996 all prospective employees will be asked to supply evidence of eligibility to work in the UK. We will ask to see an appropriate official document (for example, a document showing your national insurance number, if you have one, your birth certificate, passport etc). Do not send these now. Further information will be sent to you if you are selected. Do you require a work permit to work in the UK? Yes No If you already have a work permit, please give the expiry date Declaration To the best of my knowledge, the information I have supplied on this form is correct. I understand that giving false information or omitting relevant information could disqualify my application and, if I am appointed, could lead to my dismissal. Signed Date FOR OFFICE USE ONLY Give details below of reasons for non-selection related to details provided Selection stage QUALIFICATIONS KNOWLEDGE SKILLS OTHER Invited for interview Yes No Offered job Yes No Please indicate if: appointed withdrew other GUIDANCE NOTES Completing the application form • In addition to these Guidance Notes, please read carefully the notes you will find at the various sections on the application form. • If you would like the application form in another format because of a disability (e.g. Braille, large print or floppy disk) please contact the department that supplied you with this application form. • We will accept applications in other formats, e.g. audio tape, where an applicant has difficulty in completing the form because of a disability or learning difficulty. • Read the job description and any other documentation you have been sent before completing the form. Tailor your responses to the job for which you are applying. • We will use the information you supply to assess how well you meet the selection criteria, as set down in the details provided. Make sure you include evidence relating to as many of the aspects of the post as possible. • Include experience and achievements from any sphere of your life. You could include evidence of knowledge and skills gained through voluntary work, involvement in community activities, managing a home and family, school / college and special interests as well as previous paid employment. Tell us about any unpaid work you do or any position of responsibility you hold, for example in a club, or organisation you belong to. • Complete all the shaded sections where questions are posed. You may complete the form by hand (in black ink please to assist photocopying) or by typing your responses. Include extra sheets if there is not enough room in the boxes provided. • If you would like us to acknowledge receipt of your application form, please enclose a stamped, addressed envelope marked “A” in the top left-hand corner. If you wish to be informed once the post has been filled, please enclose a second stamped, addressed envelope. Equal opportunities policy “Suffolk County Council confirms that its employment policy aims to offer full equality of opportunity. Employees and prospective employees will not be unfairly discriminated against on grounds of their gender, marital status, colour, race, nationality, belief, culture, ethnic or national origin, religion, disability, sexual orientation, age, trade union membership or non-membership. Where an employee may be disadvantaged on these grounds, the County Council will make every reasonable effort to rectify such disadvantage(s). Employment terms and conditions and decisions on recruitment, selection, training, promotion and dismissal will be made solely on the basis of objective criteria.” A separate leaflet called “Working towards equality of opportunity” explains the County Council’s flexible working arrangements, age (discrimination) policy, policy on employing disabled people and monitoring arrangements. If you have not had a copy and would like one, please ask. Job Sharing It is County Council policy to consider applications for job sharing for all full-time posts unless this is not practicable in the particular circumstances that apply. You do not need a job share partner in order to apply to job share. Disability / health If you have indicated that you have a disability or a long-term medical condition and provide evidence that you meet all the essential criteria for the post (with any reasonable adjustments), you will be offered an interview as part of the County Council’s commitment to the employment of disabled people. Please tell us about any adjustments that would help you apply for this post or carry out the job, if successful. For example, where the job entails visiting different parts of the county, tell us if you are unable to drive because of a disability. Please also tell us if you would have difficulty lifting heavy objects where the job could require this. The County Council may be able to make alternative arrangements. W e may also be able to provide sign language interpreters, time off for treatment, rest breaks during the day, special equipment, workplace adaptations, etc. All employees are required to complete either a health / disability declaration or a medical questionnaire, depending on the nature of the work. Some employees, especially those who handle food or who work with vulnerable groups such as children or the elderly, may also be required to provide specimens and/or attend a Suffolk County Council Education STATEMENT OF POLICY ABOUT RELEV ANT CONVICTIONS The Job for which you are applying involves substantial opportunity for access to children. It is therefore exempt from the Rehabilitation of Offenders Act, 1974. You are therefore required to declare any convictions or cautions you may have, even if they would not otherwise be regarded as “spent” under this Act. This information you give will be treated in confidence and will only be taken into account in relation to an application where the exemption applies. The Council is also entitled, under arrangements introduced for the protection of children, to check with the police for the existence and content of any criminal record of the successful applicant. Information received from the police will be kept in strict confidence and wil be destroyed immediately the selection process is completed. The disclosure of a criminal record will not debar you from appointment unless the selection panel considers that the conviction renders you unsuitable for appointment. In making this decision the panel will consider the nature of the offence, how long ago and what age you were when it was committed and any other f actors which may be relevant, including appropriate considerations in relation to the Council’s published Equal Opportunities Policy. Failure to declare a conviction may, however, disqualify you from appointment, or result in summary dismissal if the discrepancy comes to light. If you would like to have further advice or to discuss, in confidence, whether a conviction you have would debar you from working with children you may telephone Jenny Wagstaff or Jan Pettifer, Area Personnel Officers, on direct dial (01502) 405213.
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