Step 1 of 7 14% Post applied for:*National Insurance Number:*Title:MrMrsMissMsOtherFirst Names:*Surname:*DFES/DCSF Number:Do you have?QTSQTLSAddress:* Street Address Address Line 2 City County Postcode Telephone No:Mobile No:*Email:* FOR MONITORING PURPOSES ONLY: Nelson and Colne College is committed to ensuring fairness and equal access to all employees and potential employees. The following questions are for monitoring the protected characteristics under the Equality Act 2010 and we ask you to respond positively as it will help us ensure we do not inadvertently discriminate. Information collected here will be treated as strictly confidential and will not be made available to members of the selection panel.Are you:*MaleFemalePrefer not to sayDate of Birth: DD MM YYYY What is your religious belief?BuddistChristianHinduJewMuslimSikhNo religionPrefer not to sayDo you have any special requirements in terms of religious belief?What is your sexual orientation?BisexualGay manGay woman/lesbianHetrosexual/straightPrefer not to sayWhat is your marital status?DivorcedSeparatedMarriedSingleWidowCivil partnerPrefer not to sayDo you consider yourself to have a disability or have a long-term health condition?*YesNoPrefer not to sayWhat is the impact or impairment of your disability or health condition?This question is asked to ensure that individuals receive the opportunity of an interview if they meet the essential requirements for the post. If you have answered yes to the above question could you please give details below including any practical steps which we should take into account when arranging an interview. Ethnic origin:IndianPakistaniBangladeshiCaribbeanAfricanChineseWhite and Black CaribbeanWhite and Black AfricanWhite BritishWhite IrishPlease state your nationality:*The Asylum and Immigration Act 1996 In accordance with this Act, any offer of appointment would be subject to the successful candidate having the right to work in UK.Do you require a work permit to work within the UK?*YesNoIf yes, do you hold a current work permit?YesNoWhere did you see the advert?*Nelson and Colne College Careers SiteNewspaperJob CentreIndeedTES Education and Qualifications:*Include in this section all relevant qualifications, i.e. Secondary, Further, Higher and Professional. Include subjects currently being studied for with an asterisk(*)Subject/QualificationPlace of StudyGrade/ResultsMonth/Year Obtained Non Qualification Courses (e.g. Health and Safety at Work):Provider of TrainingYear and Duration (e.g 2000, 6 weeks x 2hrs)Content of Training Membership of Professional BodiesPlease give details of any professional bodies or associations to which you belong. Organisation(s)Registration NumberRenewal Date Current/Most Recent Employment:*Date FromDate ToName of employerPositionBrief outline of dutiesReason for leaving (if applicable)Present/last salaryState whether full-time/ part-timePeriod of NoticePrevious Employment:*Please give details of all previous positions (most recent first) held since full-time education. Please also explain any gaps in employment (continue on a separate sheet if necessary). Please note the College reserves the right to contact each previous employer for verification of details provided.Date FromDate ToName of employerPositionBrief outline of duties Student exam results for the past 3 years:(to be completed by teaching staff only) DateQualificationBoardPass RateHigh GradesRetention (%)Added ValueNumber of Students Supporting Statement*State how your experience and skills gained through study, training, employment etc. meet each of the criteria detailed in the person specification. Please do not attach a copy of your CV as it will not be considered. References Please give the names and addresses of two people who can provide an assessment of your suitability for this post. One referee must be your recent employer. If you are a student, give an academic referee. We are unable to accept personal references. Referee 1Referee 1: Name*Relationship to you:*Address:* Street Address Address Line 2 City County Postcode Telephone:*Email:* Referee 2Referee 2: Name*Relationship to you:*Address:* Street Address Address Line 2 City County Postcode Telephone:*Email:* General Information The Rehabilitation of Ex Offenders Act 1974 Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act (Exemptions) Order 1975 as amended. Applicants are, therefore, not entitled to withhold information about convictions, cautions or final warnings which for other purposes are "spent" under this Act. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the Order applies. Certain posts, where the postholder may come into contact with under 18s and vulnerable adults, will be subject to checks by the Disclosure and Barring Service. Have you ever had any criminal convictions, cautions or bind overs (including spent)?*YesNoAre you currently subject to any ongoing police enquiry?*YesNoDisclosure and Barring Service (DBS) Check All appointments are subject to satisfactory checks including those required under the provisions of the Protection of Children Act Part V of the Police Act 1997. A criminal record will not necessarily bar you from employment. You will be required to complete a DBS application form. The DBS/Recruitment of Ex Offenders Policy is available by request from the HR Department. Driving Details Do you have a current driving licence?*YesNoDo you have access to a car?*YesNoDeclaration I confirm that the information I have given on this form is correct and understand that if selected, an enhanced disclosure will be sought from the DBS. Data Protection Act 1998 Your signature on this document gives the College the right under the Data Protection Act 1998 to process the information you have given, including data of sensitive nature, for processes relating to your application for employment, which have been notified to the offices of the Information Commissioner. Any processing of the data by the College will be in accordance with the College's Data Protection Policy and the processing principles set out in the Act. Application forms of unsuccessful candidates will be destroyed after 6 months. Signature*Date* Date Format: DD slash MM slash YYYY