Application For Employment

Post Reference Number:

Post applied for:

Service Unit:

Directorate:

Salary:

Grade:

Closing date for application:

Present Appointment:

Name & Address of Employer:

Present Grade (if applicable):

Salary:

Date started present post:

Period of notice required:

Duties & Responsibilities:

College, University:

Qualifications achieved and grades - state whether GCSE/CSE/GCE/ONC/Degree/RSA/Northern Counties/NVQ etc.

Type/subject: Grade:
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Do you possess a clean driving licence? Yes No

Do you have your own transport? Yes No

Membership of Professional Bodies

Name of Professional Body: Grade:

Current Member: Yes No

Name of Professional Body: Grade:

Current Member: Yes No

Name of Professional Body: Grade:

Current Member: Yes No

Name of Professional Body: Grade:

Current Member: Yes No

Previous Appointments - (please list in date order, most recent first)

Please give Employers name & address, post title and reason for leaving

Please state the approximate number of working days lost through sickness absence or injury during the last two years:

Please list the names and addresses of two referees (one of whom should be your present employer, or previous employer if currently unemployed). If you do not wish your present employer to be contacted until an appointment decision has been made please tick this box

Present employer/Most recent

Name:

Position:

Address:

Contact Number:

Referee 2

Name:

Position:

Address:

Please state why you feel you are suited to the post. Include any information concerning relevant experience, training and skills you possess which would enhance your application. Please relate your response to the details outlined in the person specification/job description for the post in question.

Where did you see this post advertised?

Canvassing of Members or Officers of the Authority will immediately disqualify candidates from further consideration.

Job title:

Post ref number:

The following information is needed to monitor the effectiveness of our systems in promoting equal opportunities at the District of Easington. Please help us by answering the following questions. This information will not be used in the selection of candidates

Title & surname:

Forename(s):

Date of Birth:

Nat. Insurance No:

Address (for correspondence):

Telephone no (home):

Telephone no (work):

E-mail address:

I would describe my ethnic origin as being:

A White:

British

Irish

Other, please specify

B Mixed:

White & Black Caribbean

White & Black African

White & Asiano

Any other mixed background, please specify

C Asian or Asian British:

Indian

Pakistani

Bangladesh

Any other Asian background, other

D Black or Black British:

Caribbean

African

Any other Black or Black British, background, please specify

E Chinese or other Ethnic Group:

Chinese

Other, please specify

Are you related to a Member or Senior Officer
of the council? Yes No

If yes, please state the name, position and the relationship (e.g. uncle, aunt, mother, father etc):

The Disability Discrimination Act (1995) came into force in December 1996 and the Act protects anyone who has a disability which makes it difficult for them to carry out normal day to day activities.

The disability could be physical, sensory or mental. It must be substantial and must last, or be expected to last for twelve months.

Do you consider yourself to be covered by the definition regarding disability as set out in the Act? Yes No

If yes, please outline briefly your disability:

What assistance do you require from the Authority in the following areas

completing application form e.g. tape, personal help in completing form, delivering the completed form

attending for interview - access to premises, travelling arrangements, timing of the interview, type of interview, induction loop etc.

carrying out the job once appointed - (e.g. hours of work, access to premises, special equipment.) Employers have a duty to consider what reasonable adjustments could be made to working practices or premises to overcome the effects of a disability

Some positions at the authority require candidates to undergo a Criminal Records Bureau check, for example a Sports Officer or Care Warden. If the advert for this position stated that a CRB check would be done please complete this section also.

Due to the nature of the work for which you are applying, this post is exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 (Exemptions) (Amendments) Order 1986 (SI 1986 No. 1429). Applicants are therefore not entitled to withhold information about convictions which for other purposes are “spent” under the provisions of the Act, and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the Authority. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the Order applies.

Have you ever been convicted in an adult Court of Law? Yes No

If yes please give details below: