www dudleycol ac uk Application for Employment Name forename by billycorgann

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									767/11/07
                                                                         www.dudleycol.ac.uk




             Application for Employment
     Name
     (forename first)



     Candidate Number
     (for Office use only)



     Post Applied for




     Post Reference




     Closing Date


                               Please return this application form to:
                             Human Resource Development Department,
                                  Dudley College ,The Broadway,
                                  Dudley,West Midlands. DY1 4AS
                                         Fax: 01384 363444




            Putting learners and our community at the
                         heart of all we do
                  Dudley College Application for Employment


                                                                                  Candidate Number (Office use only)



ADVICE ON COMPLETING THIS FORM
Please take great care in completing this form since the decision to shortlist for interview will be based entirely on the information
you provide.
All posts have a job description and person specification which lists the skills, knowledge and experience needed. Make sure you have
both the job description and person specification before you complete the form; unless you clearly demonstrate in your application
how you meet the requirements specified you may not be shortlisted.
The form will be photocopied, so you should use black or blue ink.
When you complete Section 5 you may wish to include experience/training/skills that you have obtained through employment, or at
home, or within the community, which meet the requirements of the job description and person specification. In addition, you are
invited to include within this section any other relevant information about yourself not included elsewhere.
Pages 1, 6 and 7 of the form will be separated before shortlisting; the shortlisting panel will make their decisions on pages 2 to 5
without access to any personal information.
The Application Form is also available in other formats, e.g. Braille. Should you require any other format or any assistance in
completing the form, please contact the Human Resource Development Department.

You should therefore not include a curriculum vitae with your application.

Application for the Post of                                                       Post Reference No



Section 1: Personal Details
FULL NAME: Surname                                               Other Names


Mrs/Miss/Ms/Mr/Dr/Other                                          Previous Surname


Home Address




                                                                             Post Code

Correspondence Address (if different from above)




                                                                             Post Code

TELEPHONE: Home                                                  TELEPHONE: Business Daytime
                                                                 (only if we may contact you on this number)

TELEPHONE: Mobile                                                E-mail address

Date of Birth                                                    National Insurance Number




Page 1 of 7
                                                                                  www.dudleycol.ac.uk
                                                                                 Candidate Number (Office use only)



Section 2: References
Please give full name and address of two referees who will be able to provide a reference on your professional capability and
suitability for the post. One of them should be your present or most recent employer.

REFEREE 1                                                        REFEREE 2
Name                                                             Name


Job Title                                                        Job Title


Address                                                          Address




Post Code                                                        Post Code


Tel No.                                                          Tel No.


Fax No.                                                          Fax No.


Email Address                                                    Email Address


Referee’s Relationship to you                                    Referee’s Relationship to you


May we seek reference prior to interview? Yes          No        May we seek reference prior to interview?     Yes      No


Section 3: Current Post A
Post Held                                                        Department


Name of Employer


Address of Employer




                                                                 Postcode

Date Appointed to post                                           Basic Salary


Additional Allowance(s)                                          Grade




                                                                                                                       Page 2 of 7
                    Dudley College Application for Employment


                                                                                   Candidate Number (Office use only)



 Give brief details of duties and responsibilities of your present or most recent post:




 Reason for leaving?




 How much notice are you required to give to your present employer?



DETAILS OF PREVIOUS EMPLOYMENT
If part time, please state number of hours per week.
PLEASE LIST MOST RECENT FIRST.

                                                                                           Annual
                    Employer Name and Address                          Job Title                             Reason for Leaving
                                                                                           Salary
B



C



D



E



F



Please note: You will be required to provide details of all periods of employment including dates from and to if successfully appointed.


Do you have a full driving licence?      Yes      No            Do you have regular use of a           Yes       No
                                                                car/motorcycle?

Do you hold a current First Aid At Work Certificate?          Yes       No



Page 3 of 7
                                                                                 www.dudleycol.ac.uk
                                                                                Candidate Number (Office use only)



Section 4: Secondary/Further Education and Examination Results
QUALIFICATIONS (please specify full-time, part-time, sandwich courses etc.)
                                          PLEASE LIST MOST RECENT FIRST.

                                                                                                                    Expected
                                                                                                    Grade
                School/College/University            FT/PT          Qualifications Obtained                     Achievement Date
                                                                                                   Achieved
                                                                                                                    (MM/YY)
1

2

3

4

5


    Please note: You will be required to provide evidence of all relevant qualifications if successfully appointed

DETAILS OF MOST RECENT TRAINING COURSES ATTENDED
                               Course                                                         Organising Body




PROFESSIONAL MEMBERSHIP
Please give details of any professional membership you currently hold:



Are you a qualified teacher? Yes               No
                                                                    If you hold a DfES number, please state below:
If Yes, please indicate qualifications held:

BEd                                                                 Will this be your first teaching post? Yes         No
PGCE
Cert Ed                                                             Special Subjects Offered:
7407 Stage 3
7407 Stage 2
7407 Stage 1
Other


                                                                                                                     Page 4 of 7
                   Dudley College Application for Employment


                                                                                Candidate Number (Office use only)



Section 5: All Posts
Please summarise the reasons for your application and provide details of how you meet the requirements of the job description
and person specification.You should refer to the criteria outlined in the job description and person specification sent with this
form; these will be used in the selection process.You can demonstrate your suitability for the post using examples from previous
work, vocational and voluntary experience.This information can be provided on a separate sheet if you wish; please make sure it
is securely attached to the form.




Page 5 of 7
                                                                                       www.dudleycol.ac.uk
                                                                                     Candidate Number (Office use only)



Section 6: Equality Monitoring
    GENDER: Male          Female

DISABILITY: Do you have a disability or condition that you would like the college to know about?                   Yes      No

If yes, is there any assistance you would like the College to provide at interview or for you to carry out this job?


If you wish to take advantage of the law relating to disability and of the College’s policy regarding the employment of people with
disabilities you must advise the College of your disability. Please give details of your disability:



Are you currently eligible to work in the UK?                                                                      Yes      No

To which of the following groups would you say you belong? (Please tick one box only)
African                                        Indian                                              Other
Bangladeshi                                    Mixed White/Asian                                   Pakistani
Caribbean                                      Mixed White/Black African                           White British
Chinese                                        Mixed White/Black Caribbean                         White Irish

FOR MONITORING AND SALARY ASSESSMENT
Dates of previous employment as listed in Section 3 (page 3). PLEASE LIST MOST RECENT FIRST.
                                                                                                             Dates employed
                                          Employer Name
                                                                                                           (MM/YY) to (MM/YY)
A

B

C

D

E

F


Dates of each of the qualifications listed in Section 4 (Page 4). PLEASE LIST MOST RECENT FIRST.

                 School/College/                                                                                   Date gained
                                                                Qualification
                   University                                                                                       (MM/YY)
1
2
3
4
5



                                                                                                                           Page 6 of 7
                      Dudley College Application for Employment


                                                                                                Candidate Number (Office use only)




Section 7: Other Information
Are you related or known to any member of Dudley College of Technology Corporation or member of staff?                                   Yes          No
Name of Person                                                                 Relationship
  (A candidate who fails to disclose such a relationship shall be disqualified from the appointment and if appointed could be liable to dismissal without notice)
ANY CANVASSING WILL DISQUALIFY CANDIDATES

Please state where you saw the post advertised (include newspaper title, journal title, website etc)




Section 8: Disclosure of Criminal Background
Successful candidates will be required to undertake an enhanced Criminal Records Bureau (CRB) Disclosure check.

You are asked to give details of any convictions including those which for other purposes are 'spent' under the provision of the Act. If
you are offered employment, then any failure to disclose such convictions could result in dismissal or disciplinary action by the
College. All convictions must be included. If you have no convictions then please write 'none'.

Date


Police Convictions, Cautions, Reprimands and Final Warning



Sentence



Declaration
I declare that the information given above and in any supporting documents is true and that nothing has been omitted that would
affect the application. I understand that any false or misleading information given in this application may render my contract of
employment, if I am appointed, liable to termination. I agree that information provided on this application form can be used for data
processing as defined in the Data Protection Act 1998.


Signed                                                                                                        Date



                    Dudley College actively promotes equality and celebrates diversity.
                            Thank you for completing this application form.

								
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