Application Form - Amazon S3
Application Form
|Position Applied For: |
|Section 1 – Personal Details |
|Title: |Forename(s): |Surname: |
|Dr/Mr/Mrs/Miss/Ms | | |
|Address: |Former names: |
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|Postcode: | |
| |Preferred name: |
| |National Insurance Number: |
| |Are you currently eligible for employment in the UK? |
| |Yes ο No ο |
| |Please provide details: |
|Telephone Number(s): |Teacher’s R P Number (if applicable): |
|Home: | |
|Work: | |
|Mobile: | |
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|Email Address: | |
| |Are you registered with the GTC for England? |
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| |Yes ο No ο |
| |Do you have Qualified Teacher status? |
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| |Yes ο No ο |
|Are you related to or do you maintain a close relationship with an existing employee, volunteer, Governor or Trustee of either Stonyhurst College or|
|Saint Mary’s Hall? If so, please provide details. |
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|Section 2 – Education |
|Please start with the most recent |
|Name of School/College/University |Dates of Attendance |Examinations |
| | |Subject |Result |Date |Awarding Body |
|Section 3 – Other Vocational Qualifications, Skills or Training |
|Please provide details of any vocational qualifications or skills that you possess or training that you have received which you consider to be |
|relevant to the role for which you have applied. |
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|Section 4 – Employment |
|Current/most recent employer: |Current/most recent employer’s address: |
|Current/most recent job title: |Date started: |
|Brief description of responsibilities: |Date employment ended (if applicable): |
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|Current salary/ salary on |Do you/did you receive any employee benefits? If so, please provide details of these. |
|leaving: | |
|Reason for seeking other employment: |
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|Please state when you would be available to take up employment if offered: |
|Section 5 - Previous Employment and/or Activities since leaving secondary education |
|Please continue on a separate sheet if necessary |
|Dates |Name and address of employer |Position held and/or duties |Reason for leaving |
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|Section 6 – Interests |
|Please give details of any interests, hobbies or skills that you could bring to the School for the purposes of extra curricular activity |
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|Section 7 – Suitability |
|Please give your reasons for applying for this post and say why you believe you are suitable for the position. Study the Job Description and Person|
|Specification and describe any experience and skills you have gained in other jobs or similar environments which demonstrate your ability and |
|aptitude to undertake the duties of the post. Continue on a separate sheet if necessary. |
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|Section 8 – Health |
|Stonyhurst (Stonyhurst College, Saint Mary’s Hall) is an equal opportunities employer and welcomes applications from disabled candidates. The |
|purpose of the following questions are to ensure that Stonyhurst complies with its obligations under the Disability Discrimination Act 1995 (“the |
|Act”). For the purposes of the Act a disability is defined as a physical or mental impairment, which has a substantial and long-term adverse effect|
|on a person’s ability to carry out normal day to day activities. |
|Do you consider yourself to be disabled? Yes ο No ο |
|If you wish please give further details here |
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|………………………………………………………………………………………………………………………………... |
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|………………………………………………………………………………………………………………………………... |
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|Are there any special arrangements you might require to attend an interview? Yes ο No ο |
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|If yes, please give details here |
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|………………………………………………………………………………………………………………………………... |
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|………………………………………………………………………………………………………………………………... |
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|If offered the position applied for, (on the basis of the Job Description provided) are there any arrangements or adjustments that Stonyhurst would |
|need to make to enable you to carry out the role? Yes ο No ο |
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|If yes, please give details here |
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|………………………………………………………………………………………………………………………………... |
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|In accordance with the guidance published by the DfES any offer of employment made by Stonyhurst will be conditional upon the School verifying the |
|successful applicant’s medical fitness for the role. Therefore, if your application is successful, you will be required to complete a medical |
|questionnaire the responses to which will be assessed by the Stonyhurst’s (Stonyhurst College, Saint Mary’s Hall) medical adviser before any offer |
|of employment is confirmed. There may be circumstances when it will be necessary for the Stonyhurst’s (Stonyhurst College, Saint Mary’s Hall) |
|medical adviser to be given access to your medical records and/or for you to be referred to a specialist clinician |
|Section 9 – Criminal Records |
|An offer of employment is conditional upon Stonyhurst receiving a satisfactory Disclosure from the DBS. If you are successful in your application |
|you will be required to complete a Disclosure and Barring Service application form. Any information disclosed will be handled in accordance with |
|the Code of Practice published by the Disclosure and Barring Service (a copy of which is available from Stonyhurst on request). |
|As the job for which you are applying involves the opportunity for access to children, it is important that you provide us with legally accurate |
|answers. |
|Upfront disclosure of a criminal record may not debar you from appointment as we shall consider the nature of the offence, how long ago and at what |
|age it was committed and any other relevant factors. Please submit information in confidence enclosing details in a separate sealed envelope which |
|will be seen and then destroyed by the Headmaster. If you would like to discuss this beforehand, please telephone in confidence to the Headmaster |
|for advice. |
|Please disclose any unspent convictions, cautions, reprimands or warnings. Please note that the amendments to the Exceptions Order 1975 (2013) |
|provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers, and cannot be taken into |
|account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website |
|.uk/dbs |
|You should be aware that the School will institute its own checks on successful applicants for short listing with the Disclosure and Barring |
|Service. |
|Failure to declare any convictions (that are not subject to DBS filtering) may disqualify you for appointment or result in summary dismissal if the |
|discrepancy comes to light subsequently. |
|I have nothing to declare I enclose a confidential statement |
|Section 10 – References |
|Please supply the names and contact details of two people who we may contact for references. One of these must be the Head of your current or most |
|recent school. If your current/most recent employment does/did not involve work with children, then your second referee should be from your |
|employer with whom you most recently worked with children. Neither referee should be a relative or someone known to you solely as a friend. |
|Stonyhurst intends to take up references from all shortlisted candidates before interview. |
|Referee 1 |Referee 2 |
|Name: |Name: |
|Organisation: |Organisation: |
|Address: |Address: |
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|Occupation: |Occupation: |
|Telephone Number: |Telephone Number: |
|Email Address: |Email Address: |
|May we contact prior to interview? Yes ο No ο |May we contact prior to interview? Yes ο No ο |
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|Section 11 – Recruitment |
|It is the Stonyhurst’s (Stonyhurst College, Saint Mary’s Hall) policy to employ the best qualified personnel and to provide equal opportunity for |
|the advancement of employees including promotion and training and not to discriminate against any person because of their race, colour, national or |
|ethnic origin, sex, sexual orientation, marital status, religion or religious belief, disability or age. All new posts within Stonyhurst are |
|subject to a probationary period. |
|Stonyhurst is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this |
|commitment. |
|A copy of the Stonyhurst’s (Stonyhurst College, Saint Mary’s Hall) Recruitment Policy is enclosed with this Application Form. Please take the time |
|to read it. |
|If your application is successful, Stonyhurst will retain the information provided in this form (together with any attachments) on your personnel |
|file. If your application is unsuccessful, all documentation relating to your application will normally be confidentially destroyed after 6 months.|
|However, please indicate below if you would like Stonyhurst to retain your details on file so that you can be notified of future vacancies which may|
|be of interest to you. |
|Would you like Stonyhurst to retain your details if your application is unsuccessful? Yes ο No ο |
|Section 12 – Declaration |
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|I confirm that the information I have given on this application form is true and correct to the best of my knowledge. |
|I confirm that I am not on List 99, disqualified from work with children or subject to sanctions imposed by a regulatory body. |
|I understand that providing false information is an offence which could result in my application being rejected or (if the false information comes |
|to light after my appointment) summary dismissal and may amount to a criminal offence. |
|I consent to Stonyhurst processing the information given on this form, including any 'sensitive' information, as may be necessary during the |
|recruitment and selection process. |
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|Signature ………………………………………………………………. Date ……………………….. |
|Equal Opportunities Monitoring Form |
|Stonyhurst St Mary’s Hall is committed to ensuring that applicants and employees from all sections of the community are treated equally and not |
|discriminated against on the grounds of gender, colour, race, nationality, marital or civil partnership status, religion or belief, sexual |
|orientation, disability or [age]. |
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|This form assists us in monitoring who is applying for employment with us, our adherence to equal opportunities best practice and our progress |
|towards identifying any barriers to diversity among our workforce. We ask some questions regarding disability which may also assist us in |
|determining whether any reasonable adjustments are necessary to facilitate your interview. |
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|This form will be separated from your Application Form on receipt and kept securely. |
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|We would be grateful if you would fill in this form and return it with your Application. You are not obliged to answer all the questions but the |
|more information you supply, the more effective our monitoring will be. All information supplied will be treated in the strictest confidence. Thank|
|you for your assistance. |
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|Please complete in block capitals or typescript, ticking the boxes which most closely relate to you. |
|1. Please state which job you have applied for and the date of your application. |
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|Job applied for:...................................................... |
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|Date of application:................................................ |
|2. Where did you hear about the job for which you have applied? |
|Newspaper (please specify which one) [pic] ……………………………………….. |
|School Website [pic] Agency [pic] |
|Friend [pic] |
|Other (please specify) [pic] ……………………………………….. |
|3. What is your gender (please tick)? |
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|Male [pic] |
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|Female [pic] |
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|If you are currently undergoing the process of gender reassignment, please tick your future gender. |
|4. Is your age between (please tick)?: |
|16-24 [pic] 25-34 [pic] 35-44 [pic] |
|45-54 [pic] 55-64 [pic] 65 or over [pic] |
|5. How would you describe your nationality and/or ethnicity (please tick)? |
|White: |
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|Black or Black British: |
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|Chinese or other ethnic group: |
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|British — English, Scottish or Welsh |
|[pic] |
|Caribbean |
|[pic] |
|Chinese |
|[pic] |
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|Irish |
|[pic] |
|African |
|[pic] |
|Any other ethnic group |
|[pic] |
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|Any other white background |
|[pic] |
|Any other Black background |
|[pic] |
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|Mixed race: |
|[pic] |
|Asian or Asian British: |
|[pic] |
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|White and Black Caribbean |
|[pic] |
|Indian |
|[pic] |
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|White and Black African |
|[pic] |
|Pakistani |
|[pic] |
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|White and Asian |
|[pic] |
|Bangladeshi |
|[pic] |
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|Any other mixed background |
|[pic] |
|Any other Asian background |
|[pic] |
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|6. How would you describe your sexual orientation (please tick)? |
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|Heterosexual [pic] Bisexual [pic] Lesbian [pic] |
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|Gay [pic] Prefer not to say [pic] |
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|7. How would you describe your religion (please tick)? |
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|My religion is:........................................................... |
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|I am not religious [pic] |
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|Prefer not to say [pic] |
|8. The Disability Discrimination Act 1995 ("DDA") defines a disability as a "physical or mental impairment which has a substantial and long-term |
|adverse effect on a person's ability to carry out normal day-to-day activities". An effect is long-term if it has lasted, or is likely to last, |
|over 12 months. Do you consider yourself to have a disability under the DDA (please tick)? |
|Yes [pic] No [pic] |
|I used to have a disability but have now recovered [pic] |
|Don’t know [pic] |
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|9. If you answered "Yes" to question 8, please give brief details of your condition |
|……………………………………………………………………………………………………… |
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|Please provide details of any adjustments you may require to enable you to attend and participate in the interview (including, for example, |
|induction loop/radio aid/speech-to-text reporter/BSL interpreter/other) |
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|Please provide details of any adjustments you may require to enable you to undertake the job for which you have applied |
|……………………………………………………………………………………………………… |
|……………………………………………………………………………………………………… |
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|10. For the purposes of compliance with the Data Protection Act 1998, I hereby confirm that by completing this form I give my consent to Stonyhurst|
|St Mary’s Hall processing the data supplied above in connection with monitoring compliance with its equal opportunities obligations and policy. I |
|also agree to the storage of this information on manual and computerised files. |
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|Signed......................................................................... |
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|Dated........................................................................... |
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