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APPLICATION FORM Applicants are advised to read the Guidance Notes carefully before completing the application form. PERSONAL DETAILS - Please complete this section in block capitals and black ink. Position: Ref: Department: Closing Date: How did you become aware of this vacancy (please tick)? BEP Total Jobs FE Jobs Bristol Jobs Website search SGS College Website Other please specify Are you currently employed by SGS College? Yes / No Surname: Initials: Address: Home Telephone Number: Work Telephone Number: Mobile Telephone Number: Email Address: Postcode: National Insurance No: DFEE Number: IFL Registration Number & Grade: Do you require a work permit to work in the UK? Yes / No If yes, you will be required to provide original documents at the interview stage. Do you hold a current driving licence? No Yes/ Date started teaching in FE sector? Do you have the use of a motor vehicle? Yes / No EDUCATION AND QUALIFICATIONS Establishment Qualification gained Year gained School: College / University: Other relevant courses attended in the last 5 years including job related training Establishment Course Year gained Page 1 of 6 EMPLOYMENT HISTORY – Please provide details of your current employer, followed by your past employment history since completing full-time education (including paid or unpaid work experience) in chronological order. If you have held more than 4 positions within the past 10 years please continue on a separate sheet. If you have no recent employment history, please provide details of any unpaid or voluntary work experience, if applicable. CURRENT EMPLOYER Name and address of Company From To Brief Summary of Duties Full or Part-time Position Held: Reason for leaving Salary per annum: If appointed how much notice are you required to give? If appointed to this post will you retain any other form of paid employment? details: Company: Yes / No If yes, please provide Job Title: Hours worked per week: Brief Summary of Duties Full or Part-time PAST EMPLOYMENT Name and address of Company From To Position Held: Name and address of Company Salary per annum: From To Brief Summary of Duties Position Held: Name and address of Company Reason for leaving Full or Part-time Reason for leaving Salary per annum: From To Brief Summary of Duties Position Held: Full or Part-time Reason for leaving Salary per annum: Page 2 of 6 Are you a member of a Professional or Technical Association? Yes / No If yes, please state Association, grade (if applicable) and length of membership. Are you related to any Governor or employee of SGS College? Name: Yes / No If yes, please provide details: Relationship: Position Held: REFERENCES Please provide details of two people to whom references can be made. One referee must be the line manager of your current employer; the other should be the line manager of your previous employer. If you have no previous employment please provide details of your School/College/Training Centre. NB: Internal applicants need to complete details for one referee. References will be taken up upon verbal acceptance of an offer of employment and on occasion taken up prior to interview. If you do not wish your current employer to be contacted prior to interview please tick this box. CURRENT EMPLOYER PREVIOUS EMPLOYER Referee Name: Referee Name: Job Title: Job Title: Company: Company: Address: Address: Postcode: Postcode: Telephone Number: Telephone Number: Fax Number: Fax Number: Email Address: Email Address: Capacity known to you: Capacity known to you: PERSONAL STATEMENT The advertisement, job description and person specification detail the qualifications and experience that are required for this position. Please use this space to detail your experience, training or activities which you consider relevant to the position. You may wish to provide details of any paid or unpaid experience, hobbies or other interests which could support your application. Please include the reasons why you consider yourself suitable for this position. Page 3 of 6 I confirm that the information I have given on this form is correct and complete. Signed: Date: If you are sending this application form by email then in the absence of this signature you should note that the emailing of this application constitutes your personal certification that the details in this application are correct and complete. False or misleading information on this form will disqualify you from appointment, or if appointed will render you liable to dismissal without notice. Should you be unsuccessful in your application the College will retain your paper application form on file for a period of up to one year. If you do not wish your application to be retained on file please indicate by ticking the box. Please return this form together with the Equal Opportunities Monitoring form to: Human Resources Department, South Gloucestershire & Stroud College, Filton Avenue, Filton, Bristol BS34 7AT Telephone number: 0117 909 2321 For Office Use Only Applicant No: Date Received: SLD: Fax number: 0117 909 2339 AFSL AAD Page 4 of 6 IN Email: [email protected] AFI AD EQUAL OPPORTUNITIES MONITORING FORM South Gloucestershire and Stroud College embraces diversity in all its aspects and aims to employ a workforce and attract a student body which reflects, at every level, the community it serves. Our aim is to create an environment which respects the diversity of staff and students enabling them to achieve their full potential, to fully contribute and to derive enjoyment from working and studying in the College. The College aims to ensure that all actual or potential employees and students are treated equally regardless of age, disability, family responsibility, marital status, race, colour, ethnicity, nationality, religion or belief, gender, sexual orientation, trade union activity and unrelated criminal convictions. NOTE: The data recorded on this form is classified as sensitive data under the Data Protection Act 1998 and will only be used for the above mentioned purposes and will be treated in strict confidence. All data used for reporting purposes will be anonymised to prevent individuals being identified. It will not be used at any stage of the selection process. Personal Details Forename(s) Known As Title Department Gender Marital Status Mr Male Mrs Miss Dr Position Female Unknown Single Married Divorced Surname Date of Birth Other Ref Rather not say Other Widowed Religious Beliefs (optional) The religions/faiths listed below represent the categories used in the 2011 UK population census. Please select the category which you feel best describes your religion or belief. Christian (including Church of England, Catholic, Protestant and Buddhist all other Christian denominations) Hindu Jewish Muslim Sikh No Religion Prefer not to say Any Other Religion (please specify) Sexual Orientation Please tick the box which best describes you: 1 Heterosexual 2 Gay 3 Lesbian 4 Bisexual 5 Prefer not to say 6 Unknown Please turn over and complete the reverse of this form Page 5 of 6 Disability There are many kinds of disability some more widely understood and visible than others. Many of us may have a disability that is covered by the Equality Act 2010 without even realising it. In legal terms, a person is likely to be considered disabled if they have a physical or mental impairment that has a substantial (not minor or trivial) and long term (has lasted or is likely to last for at least 12 months) adverse effect on their ability to carry out normal dayto-day activities. If you consider yourself to have a disability, please tick the box on table below which best describes you: 1 2 3 4 Yes – rather not say Yes – physical impairment No Yes – learning difficulty 5 6 9 Yes – mental ill health Prefer not to say Unknown If yes, please specify below any changes or adjustments you may require to your working conditions, the workplace, hours of work, premises, or equipment that you may find beneficial or that you may need the College to provide by way of additional training, special equipment, supervision or other arrangements with regards to your disability? Ethnic Origin Pease tick box on table below which best describes your ethnic origin: 11 Asian or Asian British – Bangladeshi 22 Mixed ethnic background, with a background of – any other 12 Asian or Asian British – Indian 23 White - British 13 Asian or Asian British – Pakistani 24 White – Irish 14 Asian or Asian British – any other 25 White – any other 15 Black or Black British – African 26 White – other European 16 Black or Black British – Caribbean 27 Any other – Gypsy, Traveller, Roma 17 Black or Black British – any other 28 Any other - Arab 18 Chinese 97 Prefer not to say 19 Mixed ethnic background, with a background of 98 Any other – White and Asian 20 Mixed ethnic background, with a background of Country of Birth – White and Black African 21 Mixed ethnic background, with a background of – White and Black Caribbean Criminal Record Having a criminal record will not automatically bar you from employment with the College. The decision will depend on the nature and circumstances of the offence. Have you ever been convicted by the courts or cautioned, reprimanded or given a final warning by the police? Yes / No If yes, please provide details and dates in a sealed envelope (Note, the post you have applied for is exempt from the Rehabilitation of Offenders Act 1974 which means that all convictions, cautions, reprimands and final warnings on your criminal record need to be disclosed. If you are invited to interview you will be required to complete a Criminal Records Application Form, a copy of the CRB Code of Practice is available on request). Health Please state the number of days and reasons for absences from work / education due to sickness in the last 2 years. What is your current state of health? Signed: ________________________________________________ Date: _________________________________________________ Please return this form to: Human Resources Department, South Gloucestershire and Stroud College, Filton Avenue, Filton, Bristol, BS34 7AT Telephone number: 0117 915 2447 Fax number: 0117 909 2339 Email: [email protected] Page 6 of 6