Application form 

Guidance notes – Form 2

Thank you for considering working for us. We want to choose the best person for the job, no matter what their sex, race, disability, sexuality, religion, belief or age.  We ask you to provide dates of employment and qualifications only so we can confirm your work history. 

First, you need to fill in an application form. Once we have received your form, we will review it to see if you have the skills, experience, qualifications and so on you need to do the job. If you do, we will invite you to come to an interview.   

We have designed this application form in three parts to make sure our processes are fair.

Part A of this form asks for personal information. We use this information to contact you and provide any extra support you may need if we ask you to come for an interview.

Part B of this form asks you to provide information about your past jobs and any  experience, qualifications or skills you may have.  Try to give as much information as you can as this will help us to see if you would be suitable for the job. If you want to include a curriculum vitae (CV) to support your application, please make sure that it covers all the information we have asked for.  If you send a CV with your application, you must also fill in parts A and C of the form or we will not consider your application.

Part C of this form is for monitoring equal opportunities only. We separate it from the rest of your form and it will not be seen by anyone involved in deciding whether to offer you the job.

Please fill in this form in black ink or a black type. This is because we need to photocopy the form.  

For jobs working with children, young people and vulnerable adults (as well as some other jobs), if we choose you for the job we will also need to contact the Criminal Records Bureau to find out if you have a criminal record.  A criminal record will not automatically stop you from getting the job, but we will consider the nature of the offence when assessing how suitable you are for the job.  If you fail to fill in a disclosure form when we ask, we will not be able to employ you.   You can find more information about this in our ‘Disclosing Criminal Convictions’ policy which we have enclosed with this application form.

If you need this form in another format (in Braille, in large print, on audio tape and so on), please phone the Job Shop at the Civic Centre on 0191 2115205 or e-mail job.shop@newcastle.gov.uk.

We look forward to receiving your application.

Application form  
Part A
Job you are applying for:
	Job reference number:	
Directorate or school:

Contact details
First names:						Last name:

Address:						Title: MrMrs Miss Ms Other
                                                                             (please say which): ..................

							
							National Insurance number:
							
							Home phone number:
							
						           May we call you at work? Yes  No 
				
E-mail:						Work phone number:

Special needs
Would you need us to make any special arrangements if we invited you for an interview, for example, providing a sign language interpreter? Yes  No 
If ‘Yes’, please say what.

References
Please provide two references, one of which should be from your present or most recent employer.
Name:

Address and postcode:

Phone number:
E-mail:

Job title:

Can we contact this person before we  interview you? Yes No 
	Name:

Address and postcode:

Phone number:
E-mail:

Job title:

Can we contact this person before we  interview you? Yes No	

Your right to work in the UK
Are there any restrictions which might affect your right to take up employment in the UK? Yes   No 

If ’Yes’, please give details.

	

Sick leave
How many days’ sick leave from work or education have you had in the last two years?  

Please give details.

Was any of this absence related to a disability?  If  ‘Yes’, please give details.

	
We need our staff to have a good attendance record and we may discuss your previous record at interview.

Flexible working

We are committed to giving you the opportunity to change your work patterns whenever possible so you can balance your work commitments with other responsibilities.   

Do you want to work full-time only?			Yes  No 

Would you like us to consider you for other 
working patterns (for example, job share, part-time, working in
term-time only and so on)?					 Yes  No 

Relationships to councillors or senior officers or school governors 

If you have any relationship with any councillor or senior council officer (or, if you are applying to a school, any school governor), please tell us their name and the relationship.

	
You must not use your relationship with councillors or senior officers to get a job with us. If you do, we will not consider your application.
Convictions

Have you ever been convicted of a criminal offence? (Do not include spent convictions, which are convictions you do not normally have to mention when applying for a job. A prison sentence of more than two and a half years can never become spent.)

Yes  No 
If ‘Yes’, please give details.

	
Note: If you are applying for a job which is not covered by the Rehabilitation of Offenders Act (for example, working with children or vulnerable adults), we will ask you to fill in an extra form which includes a question about any spent convictions.

Data protection and data matching

We will use the information on this form to recruit staff.  Because we have a duty to protect public funds, we may need to compare the information you have provided on this form with Housing Benefit records to identify people involved directly or indirectly in benefit fraud.

Declaration

I declare that, as far as I know, all the information I have given is correct.  I understand that if I deliberately give false or incomplete answers you will not consider my application or, if you have already given me the job, you may dismiss me without notice.

Your signature: ___________________________________________________________

Date:______________________________________________________________

Unless we say otherwise, please send in your filled-in application form to the address below. If you are applying to a school, please send your form direct to the school.

Employee Admin Services
Room 505
Newcastle City Council
Civic Centre
Newcastle upon Tyne
NE99 1FR 

Part B

Your past jobs

Please list all the jobs you have had in the past 10 years (or since leaving school if this is less than 10 years). Explain any times when you were not working (for example, unemployed, looking after children and so on) and give the dates you worked for each employer and why you left. Continue on the next page if you need more space.   

Employer’s name	What did you do (what was your job title)?	When did you work there and why did you leave?	

			

			

			

			

			

Experience and skills 

Please give details of any relevant experience or skills (for example, qualifications you have achieved or work-related training you have been on) which is relevant to the job you have applied for. Continue on the next page if you need to.    

What did you do?

	When did you do it?

	
Continue on another sheet if you need to.

This page is blank

If you need extra space for your past jobs or qualifications and experience, use this space.

Part C

Monitoring equal opportunities

Name:	
Job you are applying for:
	Reference number:	
Directorate or school:

Equality in employment

We aim to have a workforce that reflects the different customers we have.  To measure our performance in meeting this aim, we collect information from people applying for jobs.  We separate this part of your application from the rest of your application form. The information you give is confidential and will not be seen by anyone involved in the recruitment process. It will not affect our decision on your application.

Please provide details about yourself by ticking the relevant boxes.

Sex

Are you:		male?              female?  

Disability
The Disability Discrimination Act defines a disability as ‘a physical or mental impairment which has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities’.

Do you consider you have a disability under this definition?	 Yes 		 No 

Are you responsible for caring for anyone?
I am not responsible for caring for anyone.		I care for another relative.		
I care for children. 
		I care for someone else (please say who).		

		

Which age group do you fit into?

16 to 24                 25 to 44                 45 to 64                  65 to 74 

How would you describe your ethnic background?
White:		Black or black British:		
British		Caribbean		
Irish		African		
Any other white background		Any other black background		
				
Asian or Asian British:		Mixed:		
Indian		White and black Caribbean		
Pakistani		White and black African		
Bangladeshi		White and Asian		
Any other Asian background		Any other mixed background		
				
Chinese or other ethnic group:				
Chinese				
Any other ethnic group				

Marriage or civil partnership – please tick the box which applies to you
Please tick the appropriate box to show which applies to you. 
Married		In a civil partnership		
Divorced		My civil partnership has been legally ended		
Widowed			Single		

How would you describe your sexuality?
Heterosexual		Gay woman or lesbian		
Gay man		Bisexual		
I would rather not say.				

How would you describe your religion and beliefs?
Buddhist		Christian (Church of England, Catholic, Protestant and other Christian denominations)		
Hindu				
Muslim		Other		
Sikh		No religion		
Jewish		I would rather not say.		

Where did you find out about this vacancy?
Our jobs bulletin		Website		
Local press		National press		
Other (please say which)			

People who already work for us

Do you work for us?     Yes 	 No 		

If ‘Yes’, would this job be promotion for you?	Yes 		 No