ࡱ> AD>?@U >bjbjnn Xaa4#TpTjV p8$L$$$8&>v&& ijkjkjkjkjkjkjHmokj'&"8&''kj$$j6I)I)I)'v$$ijI)'ijI)I)2Z^$pte'L+\.Ujj<jY\Jp'p\^^vp1_$ &&I)& &S&&&kjkj(&&&j''''p&&&&&&&&&B J:  Application for Employment This form has three parts: You must fill out Part 1 to provide the information we need to consider your application. We only need you to fill out Part 2 for posts where we have to carry out additional screening procedures. You should only fill it in if we have told you that it needs to be completed. Part 3 is optional but if you fill it out it will help us to make sure that our equal opportunities policy works and that we are advertising in the right places. It will also give us some information that we will need if we employ you. We will separate this part from the rest of the form when we get it. We will not use it as part of the selection process. Position applied forDepartmentVacancy referenceApplicant reference (office use only)  PART 1 PERSONAL DETAILS TitleMr / Mrs / Ms / Miss / Dr / Other:Given name(s)Family nameCurrent address Post code Primary telephoneSecondary telephoneE-mail addressImmigration statusAre you a settled worker (i.e. do you have the permanent right to work in the UK for example as a British or EEA citizen)? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If no, do you already have temporary permission to work in the UK? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If yes, please specify your visa type and visa end date: UK National Insurance number (where held)   EDUCATION, QUALIFICATIONS & TRAINING Education below degree level We do not need full details of your GCSEs and A-Levels (or equivalent qualifications). Please give your total number of GCSEs and A-Levels (or equivalents) at grades A*-C. Please use the Other details section of the table to give any other information which is relevant, for example, if you have a GCSE or A-Level in a subject that is relevant to this job, if you have AS-Levels or if you have overseas qualifications. The total number of GCSEs (or equivalent) I have at Grade A* to C isThe total number of A-Levels (or equivalent) I have at Grade A* to C isOther details of education below degree level Education at or above Degree Level and Training Starting with the most recent, please give details of your education at or above degree level and any training which is relevant to your application. We may ask you to produce qualification certificates if we ask you to come to an interview. SubjectQualification level (if applicable)Grade (if applicable)Place of learningStart dateEnd date  Professional Body Membership Please give details of any professional body membership which you hold. Professional bodyMembership levelStart date CAREER HISTORY Starting with the present, please give details of your full career history. As well as employment, please include any periods of voluntary work, travel, career breaks and unemployment. If you have worked for the University before, we may ask the relevant department about your employment record. Start dateEnd dateEmployerJob title and key responsibilities Reason for leaving or notice period (where applicable)   SUITABILITY FOR THE ROLE Please review the requirements of the role and provide evidence of how you meet these, using specific examples. It is often helpful to deal with each requirement under a separate heading. Please do not change the font size used below or type more than three sides (or write more than the equivalent by hand).  REFERENCES Please provide details of two people (not relatives or friends) who will each provide an employers reference. One of these referees must be your current or most recent employer. If you do not have a current or recent employer, please provide details of your lecturer/course tutor/unpaid work employer etc. First reference NamePositionAddress:Telephone numberE-mail addressMay we contact this referee during the recruitment process and before any offer of employment has been made to you? Yes  FORMCHECKBOX  No  FORMCHECKBOX Second reference NamePositionAddressTelephone numberE-mail address:May we contact this referee during the recruitment process and before any offer of employment has been made to you?Yes  FORMCHECKBOX  No  FORMCHECKBOX  Request for reasonable adjustments to the selection process We welcome applications from individuals with disabilities and are committed to ensuring fair treatment throughout the recruitment process. We will make adjustments to enable applicants to compete to the best of their ability wherever it is reasonable to do so, and, if successful, to assist them during their employment. We encourage applicants to declare their disabilities in order that any special arrangements, particularly for the selection process, can be accommodated. Applicants or employees can declare a disability at any time. If you wish to do so, please enter any reasonable adjustments connected with a disability which you require to be made to the selection process in the box below. If, however, you would prefer to discuss any special arrangements with us, please contact the person specified in the job advert or Further Information document as the point of contact for this vacancy. Alternatively, you may contact HR via  HYPERLINK "mailto:hr@ucfb.com" hr@ucfb.com  APPLICANT DECLARATION Please read the statements below and then sign and date to confirm your acceptance of them. I understand how UCFB will use and store my personal data, having read the data privacy notice  HYPERLINK "https://www.ucfb.com/wp-content/uploads/2018/05/UCFB-Candidate-Privacy-Notice-0518.pdf" https://www.ucfb.com/wp-content/uploads/2018/05/UCFB-Candidate-Privacy-Notice-0518.pdf I confirm that the information I have given in this application for employment form and any supporting documents is correct and complete. I understand that failure to disclose any relevant information or the provision of false information may lead to dismissal / withdrawal of any offer of employment made to me. I understand that UCFB may check all or any of the information provided as part of my application or given in references. I understand that an appointment, if offered, will be subject to the receipt of references, and the outcome of any relevant pre-employment checks, which the University regards as satisfactory. Signature Date    PART 2 INFORMATION FOR ADDITIONAL SCREENING PURPOSES (SELECTED APPLICATIONS ONLY) For some jobs, we have to make extra checks to ensure that applicants are suitable and/or that it is legal for us to employ them. If such checks apply to this job then we will have asked you to complete one or more sections of Part 2 in the advert or Further Information document for the vacancy. Do not complete any section of Part 2 unless we tell you that you must. If you are not clear about what you have to do, please contact  HYPERLINK "mailto:jobs@ucfb.com" jobs@ucfb.com For applications to positions which are eligible for a basic disclosure Some roles require a basic disclosure. We will conduct a basic disclosure on the successful applicant through GBG online disclosures. You must now disclose any convictions you have that are unspent under the Rehabilitation of Offenders Act 1974 (as amended on 10 March 2014). Please see the  HYPERLINK "https://www.gov.uk/government/publications/new-guidance-on-the-rehabilitation-of-offenders-act-1974" Ministry of Justices web pages for further information about when convictions are considered unspent. If you do not disclose now something that is revealed by the basic disclosure then we may withdraw any conditional offer we have made (or dismiss you, if you have begun employment). We will treat the information you provide to us here confidentially and it will not be used unfairly against you. Nothing you declare here will automatically prevent you from being appointed (unless required by law). We may wish to discuss it with you if you are invited to interview. Any information revealed through the check will also be discussed with you. Do you have any convictions that are unspent under the Rehabilitation of Offenders Act 1974 (as amended on 10 March 2014)? Yes  FORMCHECKBOX  No  FORMCHECKBOX  If YES please provide further information:PART 3 EQUAL OPPORTUNITIES MONITORING (OPTIONAL) We are an equal opportunities employer and are committed to treating all job applications on their merits. We will use the information collected from this optional part of the application for statistical and monitoring purposes so that we can make sure that our equal opportunities policy is working. We will separate this part from the rest of the form when we get it. We will not use it as part of the selection process. Sensitive information will be used to generate anonymised statistics that will never be presented in a form that allows individuals to be identified. There is an option to tick prefer not to say for sensitive questions. If you do not provide any answer for a question, then we treat you as having ticked prefer not to say. If we employ you, we will have to know your gender and date of birth in order to make sure you pay the right amount of tax and National Insurance contributions. If you choose not to provide information on your gender and date of birth now, we will ask you for it again upon appointment. If you are appointed, we have to provide some of this information to the Higher Education Statistics Agency (HESA http://www.hesa.ac.uk/) without your name being associated with it. Vacancy referencePost titleApplicant reference (office use only)  Advertising Source Where did you first learn about this vacancy?Gender What is your gender? FORMCHECKBOX  Female  FORMCHECKBOX  Male  FORMCHECKBOX  Prefer not to sayDate of Birth What is your date of birth?__/__/____  FORMCHECKBOX  Prefer not to sayNationality Which country defines your national identity? Country:  FORMCHECKBOX  Prefer not to say Ethnic Origin HESA tells us what categories we have to use when we collect ethnicity data. In addition, the Equality and Human Rights Commission recommends these categories. Our use of these categories does not mean that we think that they are the most appropriate. What is your background?White:  FORMCHECKBOX  British  FORMCHECKBOX  Irish  FORMCHECKBOX  White background other Mixed:  FORMCHECKBOX  White and Black Caribbean  FORMCHECKBOX  White and Black African  FORMCHECKBOX  White and Asian  FORMCHECKBOX  Mixed background other Asian or Asian British:  FORMCHECKBOX  Indian  FORMCHECKBOX  Pakistani  FORMCHECKBOX  Bangladeshi  FORMCHECKBOX  Asian background other Black or Black British:  FORMCHECKBOX  Caribbean  FORMCHECKBOX  African  FORMCHECKBOX  Black background other Chinese:  FORMCHECKBOX  Chinese Arab  FORMCHECKBOX  Arab Gypsy or Traveller  FORMCHECKBOX  Gypsy or Traveller Other ethnic group:  FORMCHECKBOX  Other ethnic group Prefer not to say:  FORMCHECKBOX  Prefer not to say Disability HESA tells us what categories we have to use when we collect disability data. Our use of these categories does not mean that we think that they are the most appropriate. Do you regard yourself as in any way disabled? FORMCHECKBOX  Yes  FORMCHECKBOX  No  FORMCHECKBOX  Prefer not to sayIf yes, what is the nature of your disability?Please tick the appropriate box. If you experience more than one type of impairment, please tick the box next to all of the types that apply. If your disability does not fit any of these types, please tick other.  FORMCHECKBOX  Specific learning disability (such as dyslexia or dyspraxia)  FORMCHECKBOX  General learning disability (such as Downs Syndrome)  FORMCHECKBOX  Cognitive impairment (such as autistic spectrum disorder or resulting from head injury)  FORMCHECKBOX  Long-standing illness or health condition (such as cancer, HIV, diabetes, chronic heart disease, or epilepsy  FORMCHECKBOX  Mental health condition (such as depression or schizophrenia)  FORMCHECKBOX  Physical impairment or mobility issues (such as difficulty using arms or using a wheelchair or crutches)  FORMCHECKBOX  Deaf or serious hearing impairment  FORMCHECKBOX  Blind or serious visual impairment  FORMCHECKBOX  Two or more impairments and/or disabling medical conditions  FORMCHECKBOX  A social/communication impairment such as Aspergers syndrome/other autistic spectrum disorder.  FORMCHECKBOX  Other type of disability not listed above  Religious beliefs What are your religious beliefs? FORMCHECKBOX  Buddhist  FORMCHECKBOX  Christian  FORMCHECKBOX  Hindu  FORMCHECKBOX  Jewish  FORMCHECKBOX  Muslim  FORMCHECKBOX  No religion  FORMCHECKBOX  Sikh  FORMCHECKBOX  Spiritual  FORMCHECKBOX  Any other religion or belief  FORMCHECKBOX  Prefer not to say Sexual orientation What is your sexual orientation? FORMCHECKBOX  Bisexual  FORMCHECKBOX  Gay man  FORMCHECKBOX  Gay woman / lesbian  FORMCHECKBOX  Heterosexual  FORMCHECKBOX  Other  FORMCHECKBOX  Prefer not to say Gender identity What is your gender identity? 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