SCST Application FormStrictly Confidential

Please submit the completed application form and CV to: recruitment@scstrust.co.uk

Job Position:      

Personal Details

First name:     

Surname:     

Address:     Postcode:     

Home Tel no:     

How long have you lived at this address?     

Mobile Tel no:     

Email address:     Current Job Title:     

Current salary:     

Do you need a work permit? – please select one

No ☐

Yes – I already have a permit ☐

Permit expiry date:

Yes – but I do not have a permit ☐

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Supporting Information

Please refer to the Person Specification and Job Description and give examples of how you meet the job requirements. This is important, as you will be shortlisted against these criteria.

You can also draw on experience you may have gained outside of the work environment. Please provide any information you consider relevant, including your reason for applying

for the post and why you consider yourself to be suitable for the post. Remember to provide examples that demonstrate your skills, knowledge and

experience. Please limit your answers to no more than 2 pages.

     

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References

Please give the details of at least two employment referees which cover the last 5 years of employment whom we may ask about your suitability for the post.

One of these must be your most recent line manager.. Referees must not be related to you, or only able to provide personal references. If you are a school/college leaver, please give the name and address of a head

teacher/tutor and also the manager of your most recent work experience placement – if applicable.

We reserve the right to approach your current and any previous employer.

Reference 1 (most current employer) Reference 2

Name:     

Name:     

Address of organisation:     

Address of organisation:     

Tel no:     

Tel no:     

Email:     

Email:     

Occupation:     

Occupation:     

Relationship to you:     

Relationship to you:     

Dates of employment: dd/mm/yyyy     

Dates of employment: dd/mm/yyyy     

May we contact your referee prior to interview? Please Select.

May we contact your referee prior to interview? Please Select.

Reference 3 (if applicable) Reference 4 (if applicable)

Name:     

Name:     

Address of organisation:     

Address of organisation:     

Tel no:     

Tel no:     

Email:     

Email:     

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Occupation:     

Occupation:     

Relationship to you:     

Relationship to you:     

Dates of employment: dd/mm/yyyy     

Dates of employment: dd/mm/yyyy     

May we contact your referee prior to interview? Please Select.

May we contact your referee prior to interview? Please Select.

Important Information

Criminal Convictions (Rehabilitation of Offenders Act)

You are required to disclose any convictions that are current (not ‘spent’ under the Rehabilitation of Offenders Act 1974). You may be required to disclose convictions that are ‘spent’ if the post you are applying for is exempt under the Act e.g. if you will be working will be working with children or vulnerable adults, please read the General Information Section contained with in the Recruitment Pack for guidance.

Have you ever been convicted of a criminal offence or received a Police Caution?

Yes ☐ No ☐

If Yes, please give full details in a separate document. We will only take them into account if we consider them relevant to the post for which you have applied for.

     

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Equality Act 2010

The Trust wishes to encourage disabled people to apply for jobs – all information will be treated in confidence.

In relation to any disability, do you have any particular requirements in order to attend an interview?

Yes ☐ No ☐

If Yes, please give details below:

     

General

Do you hold a current driving licence?

Yes ☐ No ☐

Do you have daily use of a car?

Yes ☐ No ☐

Are you a foster carer, adoptive parent or respite carer for Slough Children’s Services Trust? If yes, please give details below:

     

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Declaration

I certify that the information provided is true and accurate and in particular that I have not omitted any facts which may have a bearing on my application. I understand that any subsequent contract of employment with the Slough children’s Services Trust will be made on the basis of the information I have provided. I understand that a false declaration which results in my appointment to the Trust will render me liable to dismissal without notice. I give explicit consent that the information which I give on this form may be processed in accordance with the Trust’s registration under the Data Protection Act 1998.

I agree to Slough Children’s Services Trust carrying out pre-employment screening relevant to my application.

Check the box to agree, and sign below. ☐

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Recruitment Monitoring Form Strictly Confidential

Job Position:      

Slough Children’s Services Trust aims to be a local employer of choice and to promote equal opportunities to all our employees. It is important that all employees feel their views are valued and included. You are not required to complete any of these monitoring sections, but telling us about your background will help us to make sure that we are meeting the needs of all our employees. All responses will be treated in confidence.

What is your Ethnic Group?Please tick ONE box from A to F to indicate your ethnicity.

A. White D. Black or Black British01 – British ☐ 61 – Caribbean ☐02 – Irish ☐ 62 – African ☐Any other white background, please state below: Any other black background, please state:

B. Mixed E. Chinese or other ethnic group21 – White and Black Caribbean ☐ 81 – Chinese ☐22 – White and Black African ☐ Other, please state:23 – White and Asian ☐Any other mixed background, please state:

C. Asian or Asian British F. Non disclosure41 – Indian ☐ I do not wish to provide this information. ☐42 – Pakistani ☐43 – Bangladeshi ☐CS– Sikh ☐Any other Asian background, please state:

Gender Date of Birth dd/mm/yyyy AgeMale ☐Female ☐

           

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Do you have a Disability? Please tick one box. ☐ 00 None☐ 01 You have a specific learning difficulty (for example dyslexia)☐ 02 You are blind or partially sighted.☐ 03 You are deaf or hard of hearing☐ 04 You use a wheelchair or have mobility difficulties.☐ 05 You have Autistic Spectrum Disorder or Asperger Syndrome.☐ 06 You have mental health difficulties.☐ 07 You have a disability that cannot be seen, for example diabetes, epilepsy or a heart condition☐ 08 You have two or more of the above.☐ 09 You have a disability, special need or medical condition that is not listed above☐ 10 I do not wish to provide this information.

What is your sexual orientation?

Bisexual ☐ Heterosexual/Straight ☐Homosexual/Gay Man ☐ Other ☐Lesbian/Gay Woman ☐ Prefer not to say ☐

What is your religion/faith/belief?Christian ☐ Buddhist ☐ Muslim ☐Sikh ☐ None ☐ Prefer not to say ☐Hindu ☐ Jewish ☐Other (please specify):

Please tick whether you are an:

Internal Applicant ☐ External Applicant ☐

Media – please state where you saw this post advertised.

☐ Slough Children’s Services Trust website☐ Slough Borough Council’s website☐ Other website, please state:☐ National newspaper, please state:☐ Local newspaper, please state:☐ Professional/trade journal, please state:☐ Other, please state:

DATA PROTECTION ACT, 1998. The data you provide on this form will normally only be used for the purpose of monitoring and managing the working time of employees. However, Slough Children’s Services Trust must protect the public funds it handles and so may use the information you have provided to prevent and detect fraud. Slough Children’s Services Trust may also share the information, for the same purposes, with other organisations that handle public funds.

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