The information on this form will be treated in strict confidence.

PERSONAL DETAILS:
Surname:		Male? Female?
First Names(s):		Date of Birth:
Home Address:
Telephone No. Mobile: Email Address:	Day:	Evening: Fax:
Do you require a Work Permit? Yes? No? [Under the Asylum & Immigration Act 1996, you will be required to produce documentary evidence of your right to work in the UK.]
Have you previously applied to Morley College: Yes? No? If Yes, please give details:

CURRENT / MOST RECENT EMPLOYMENT:
Title of Post:	Date Appointed:
Name & Address of Employer:
Current Salary:	Period of Notice:
Reason for Leaving/wanting to leave:

EDUCATION & PROFESSIONAL QUALIFICATIONS: [You will be required to produce relevant educational certificates.]
Dates	School / College / University / Professional Body	Qualification(s) gained & grade(s)

RELEVANT TRAINING:

Please list any relevant training (e.g. courses attended) and dates

FOR TEACHING POSTS ONLY:

(a) Are you recognised by the Department for Education and Skills as a qualified teacher in this country? Yes / No If yes, please give date of recognition (b) Please quote DfES number

PREVIOUS EMPLOYMENT(listed in chronological order):
Dates	Employer’s Name & Address	Job Title & Reason for Leaving	Leaving Salary

SUPPORTING STATEMENT:
Please state how your experience, skills, knowledge and training gained both inside and outside paid work or through study meet the selection criteria for the post. [You are advised to address each selection criterion in support of your application.]
(Please continue on a separate sheet.)
REFERENCES:
Two references will be required for external applicants. First referee must be your current/ most recent employer. Only one reference from line manager is required for internal applicants.
Name: Position: Organisation: Address: Telephone:	Name: Position: Organisation: Address: Telephone:

HEALTH:

Are you in good health? Yes? No? Please give details of your sickness record (nature of sickness & frequency) in the last 12 months:

Do you have any disabilities which the College needs to be aware of: Yes? No? If Yes, please give details (on a separate sheet) of the disabilities and: (a) any reasonable adjustments which you feel should be made to the recruitment process to assist you in your application; and/or (b) any reasonable adjustments that you feel should be made to the job itself, which would enable you to carry out the job.

REHABILITATION OF OFFENDERS ACT (1974):

(Declaration subject to the 1974 Act)

Have you ever been convicted of a criminal offence? Yes? No? If Yes, please give particulars (offence, judgement & date):

ETHNIC MONITORING:
Applicants are requested to tick the relevant box below to enable the College to monitor its equal opportunities policy. This information is used for no other purpose and will be treated as confidential.
ASIAN ? Asian British - Bangladeshi ? Asian British - Indian ? Asian British - Pakistani ? Asian British - any other (please specify)	BLACK ? Black British - African ? Black British - Caribbean ? Black British – any other (please specify)
MIXED   ? Mixed – White & Asian ? Mixed – White & Black African ? Mixed – White & Black Caribbean ? Mixed – any other Mixed background (please specify)	WHITE ? British ? Irish ? Any other White background (please specify)
CHINESE ? Chinese	OTHER ETHNIC GROUPS ? Any other (please specify)
Please indicate where you saw the post advertised:
DECLARATION:
I authorise the College to obtain references to support this application at any point in the selection process and release the College and referees from any liability caused by giving and receiving information. I confirm that the information given on this form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection or, if employed, dismissal.
Signature of Applicant:	Date:
The College reserves the right to seek further references from previous employers where necessary.

Дата добавления: 2015-11-14