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Job Application

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Submitted By yasirnasim
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Vacancy Applied for: Part Time Human Resources Support Officer

|Full Name |Mr/Mrs/Miss/Ms |
|Address for correspondence: |
| Post Code: |
|Tel No. |Mobile: | |Home: | |Work: | |
| |
|Email: |National Insurance No. |
| |
| |
|Are you applying for this position on a job share basis? YES NO |
| |

|Some positions with Calico are exempt from this Act as they involve varying degrees of contact with vulnerable adults. You are, therefore, required to |
|declare whether or not you have any convictions, criminal charges, summonses or cautions pending against you, whether or not your conviction is spent. |
| |
|As appropriate successful applicants will be subject to a clearance report from the Disclosure and Barring Service (DBS). |
| |
|The disclosure of a criminal record will not debar your appointment unless the selection panel considers that the conviction renders you unsuitable for |
|appointment. In making this decision the panel will consider the nature of the offence(s), how long ago and what age you were and any other factors which |
|may be relevant. |
| |
|Failure to declare a conviction may, however, disqualify you from an appointment, or result in the termination of your contract if the discrepancy comes to|
|light. |
| |
|Do you have any criminal convictions or cautions spent or otherwise YES / NO |
| |
|If yes, please give full details including dates |
| |
|___________________________________________________________________________________________________________________________________________________________|
|_____________________________________________________________________________________________________________________________________________________ |
|____________________________________________________________________________ |
|____________________________________________________________________________ |

|Calico is committed to employing a workforce that is inclusive and diverse by removing any barriers and tackling discrimination. |
| |
|INTERVIEW GUARANTEE SCHEME FOR DISABLED APPLICANTS |
| |
|If you are a disabled person and you fulfil all the essential criteria on the enclosed person specification to the satisfaction of the selection panel, you|
|are guaranteed an interview. If you wish to be included in this scheme, please indicate in the box below. |
| |
|I am disabled and would like to take part in this scheme ( please tick) |
| |
|Adjustments For Selection Purposes |
| |
|Please contact us if you need the application form in an alternative format or of you need any adjustments for the interview. |
| |
|Please note that this information does not form part of the selection process. |

| |
|Do you have any relationship with a Board Member or member of staff at Calico Yes/No |
| |
|If yes, please state their name and the nature of your relationship: |
| |
|Name: __________________________ Nature of relationship: ____________________ |
| |
|Signed: _________________________ Dated: ________________________________ |

| |
|I declare that the information provided in my application is correct and understand that if appointed, I will be liable to disciplinary action including |
|dismissal should I knowingly give false information. |
| |
|Signed: Dated: _________________________________ |

| |
|The information given above may be processed and used for recruitment, selection, statistics and monitoring purposes. If you join the Company, the |
|information will form the basis of your personal file. The data will then be processed for any purpose in connection with your employment relationship; |
|training and development; remuneration; or the effective management of the organisation. |
| |
|Signed: _________________________ Dated: ________________________________ |

Calico is committed to providing equal opportunities for everyone, regardless of ethnic origin, gender, disability, age, transgender, religion or sexual orientation and in accordance with the 9 protected characteristics of the Equality Act 2010. We therefore ask you to provide us with the information requested on this form. Please be assured that this information is used for monitoring purposes only in order to comply with current employment legislation and to promote equality of opportunity throughout the company. By monitoring this information for job applicants we are able to identify and remove any barriers that may exist for any groups or individuals. This form will be kept separately from your application form and has no part in the selection process

| |
|1. Vacancy applied for: Part Time Human Resources Support Officer |
| |
| |
|2. Ethnic origin: (*To which group would you say you belong? Please tick one box.) |
| |
| |
|WHITE INDIAN IRISH BLACK CARIBBEAN BANGLADESHI |
| |
| |
|BLACK PAKISTANI CHINESE BLACK – OTHER (PLEASE DESCRIBE) ________________ |
|AFRICAN |
| |
|OTHER – (PLEASE DESCRIBE) _______________________ |
|*These categories are approved by the Equality and Human Rights Commission |
|3. Gender |
| | |
| | |
|ARE YOU: MALE FEMALE | |
| | |
|4. Transgender | |
| | |
| | |
|If you are permanently living in the gender not of your birth please tick | |
| | |
| | |
| | |
|5. Disability | |
| | |
| | |
|ARE YOU DISABLED NO YES (please refer to Personal Information Form) | |
| | |
| | |
| |
|Age – Please tick the category to which you belong |
| |
| |
| |
|UNDER 25 25-34 35-54 55-64 >64 |
| |
|7. Religion/Faith (Please tick the category to which you belong) |
| |
|Atheist Buddhist Christian Hindu Jewish Muslim |
| |
|Sikh Other Prefer not to say |
| |
|8. Sexual Orientation (Please tick the category to which you belong) |
| |
| |
|Heterosexual Lesbian Gay Bi-Sexual Prefer Not to Say |
|9. Where did you INITIALLY see the advert – please tick appropriate box. |
| |
| |
|JOB CENTRE PROFESSIONAL JOURNAL INTERNAL ADVERTISEMENT |
| |
| |
| |
|CALICO WEBSITE EQUALITY BRITAIN WEB SITE |
| |
| |
|OTHER WEBSITE (which site) ______________________________________ |
| |
| |
| |
|PRESS ADVERTISEMENT (which publication) __________________________________________________ |
| |
|INTRODUCE A FRIEND SCHEME (which staff member) __________________________________________ |

| |Application For Employment |[pic] |
| |
| |
|Vacancy Applied for: Part Time Human Resources Support Officer |
| |
| |
|Present or most recent employment |
| |
|Job Title | |Date of Employment | |
|Employer | |Notice Required | |
|Reason for leaving | |Salary | |
|(if applicable) | | | |
| |
|Brief description of duties |
| |
| |
| |
| |
| |
| |
| |
| |
| |Please give details of past work you have undertaken. This can include paid work, unpaid or voluntary work, self employment |
|Past Work |or work at home. Please also include any periods of unemployment (continue on a separate sheet if necessary) |
| |
|Job |Employer |From |To |Reason for Leaving |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |

|Qualifications |

Qualifications and/or examinations passed Grade

_____________________________________________________ ______________
_____________________________________________________ ______________
_____________________________________________________ ______________
_____________________________________________________ ______________ ____________________________________________________ ______________
_____________________________________________________ ______________

|Special Training |(include any relevant short courses and development activities you have undertaken) |
| |

Details Duration of course/activity
____________________________________________ ________________________
____________________________________________ ________________________
____________________________________________ ________________________
____________________________________________ ________________________

|Driving Licence |

Do you hold a current full driving licence? Yes / No

|Please provide details of how you are suitable for the position and meet the person specification. Please include qualifications, experience, skills, |
|knowledge and any other information which you feel may be helpful to your application (continue on a separate sheet if necessary). CV’s will not be |
|accepted. |

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please return this form to: Human Resources, Calico, Centenary Court, Croft Street, Burnley, BB11 2ED

-----------------------

CONFIDENTIAL

PERSONAL INFORMATION

Candidate Ref. No

PERSONAL DETAILS

JOB SHARE

REHABILITATION OF OFFENDERS ACT 1974 (EXCEPTIONS) ORDER 1975 DECLARATION

FURTHER INFORMATION FOR DISABLED APPLICANTS

CONFLICT OF INTEREST

DECLARATION

DATA PROTECTION ACT

EQUAL OPPORTUNITIES MONITORING FORM

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