Confidential Application Form s1

CONFIDENTIAL APPLICATION FORM

Post: SENIOR GRANT MANAGER

Please complete this application in full, using black ink, typescript or word process in same format.

Surname: Forenames:

Address:

Telephone: Home: Work: Mobile:

Fax: e-mail address:

Employment History:

Present/most recent employer:

Address:

Present/most recent position held.

(job title or description): Dates: From To

Present / most recent salary and benefits:

Reason for leaving:

What is your period of notice?

1 Please give details of your duties and responsibilities:

If necessary, please continue on separate sheet.

Disclosure of convictions: Do you have any unspent convictions under the terms of the Rehabilitation of Offenders Act 1974 (i.e. have you ever been convicted of any offence, which is not considered “spent”?).

YES / NO (please delete as appropriate. If yes, please give details)

Previous Employment:

2 Please give details of your employment history, most recent first, excluding information given on page 1

Dates (from - to) Name & address of Previous Employer Position held (including key responsibilities) and reason for leaving

Unpaid / voluntary work experience: Please give details of any relevant unpaid / voluntary work experience.

Education / Qualifications:

3 Final Secondary School From - To Examinations and results

Further/Higher Education From - To Examinations and results

Additional Qualifications and Training:

Please indicate skills and training courses undertaken relevant to this appointment:

References:

4 Please give below, the details of two people whom we may contact for references, one of whom must be your current or most recent employer. If you are called for interview, we will normally contact at least one of your referees prior to interview.

Job Title:

Organisation:

Address:

Telephone no: e-mail:

Job Title:

Organisation:

Address:

Telephone no: e-mail:

Entitlement to work in the U.K In accordance with Section 8 of the Asylum and Immigration act 1996, an offer of employment will only be confirmed upon receipt of original documentation (e.g. National Insurance number, P45, Passport)

Can you provide proof of your entitlement to work in the U.K? YES / NO

Disability: If you are disabled and require an adjustment to the interview process please state what sort of adjustment you may need here:

Declaration: I confirm that all the information given on this form is true and correct and can be treated as part of any subsequent Contract of Employment.

Signed: ……………………………………….. Date: ……………………

THE CLOSING DATE FOR RECEIPT OF COMPLETED APPLICATIONS IS NOON (12 PM) on MONDAY 13TH JULY 2015.

Please e-mail this completed form, together with a supporting statement (no longer than 2 pages) explaining why you feel you are suitable for this position and how you meet the person specification, to [email protected].

If you have a disability or a health/mobility issue, which requires the Foundation to make a ‘reasonable adjustment’ (as defined by the Equality Act 2010) to enable you to attend interview, please make this clear in your application.

Interviews will be held at the Paul Hamlyn Foundation on the 23rd & 24th July only.

Thank you for your application.

CONFIDENTIAL

5 Equal Opportunities Monitoring Form

The Paul Hamlyn Foundation is committed to ensuring that no individual or group will receive less favourable treatment or is discriminated against on grounds of age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership, or pregnancy and maternity. The Foundation actively welcomes and values difference across its workforce

In order to assess how successful this policy is we have set up a system of monitoring all job applications. We would therefore be grateful if you would complete the questions on this form. We have asked for your name to enable us to monitor applications at shortlisting and appointment as well as application stage.

All information will be treated in confidence and will not be seen by staff directly involved in the selection process. The questionnaire will be detached from your application form before the form is seen by those involved in selection, store separately and use only to provide statistics for monitoring purposes. Thank you for your assistance.

Name: Date of Birth: Post applied for:

Gender: Please describe your gender

Female Male Prefer not to Say

Is your current gender the same as the one assigned at birth?

Yes No Prefer not to Say

Sexual Orientation:

Bisexual Gay Heterosexual Lesbian

Prefer not to say Other (Please Specify)

Disability: Do you consider yourself to have a disability or disabling condition?

Yes No Prefer not to Say

Religion or Belief: What is your Religion or Belief?

6 Buddhist Christian Hindu Jewish

Muslim Sikh No Religion or Belief

Prefer not to say Other (Please Specify)

Ethnicity

White British English Irish Scottish Welsh Other Black or Black British African Caribbean Other

Asian or Asian Indian Pakistani Bangladeshi British Other

Mixed White & Asian White & Black African Heritage White & Black Caribbean Other

Other Ethnic Chinese Arab Gypsy/Traveller Group Other

Prefer not to say

Where did you see this post advertised?

This form contains sensitive personal data as described by the Data Protection Act 1998. As such, the Foundation is required to receive your express permission to process this data for the purposes set out above, and asks that you sign below to confirm your acceptance.

I hereby give my consent to Paul Hamlyn Foundation processing the data supplied in this form for the purpose of recruitment and selection monitoring.

Signature: Date: