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    Application for Employment

    Role applied for
    Role Reference Number
    Closing Date
    Where did you see this role advertised?

    About you

    Title
    First Name
    Surname
    Address
    Postcode
    E-mail Address
    National Insurance Number
    Mobile Number

    General Data Protection Regulations (2018) – Recruitment Privacy Notice

    As part of the recruitment process, Active Tameside collects and processes data relating to job applicants. We are committed to being transparent about how we collect and use that data and to meeting our data protection obligations. The full Recruitment Privacy Notice can be found on our website:

    www.activetameside.com/wp-content/uploads/2014/06/Active-Tameside-Recruitment-Privacy-Notice.pdf.

    By continuing your application, do you agree that you have read and accepted our processing of your data in line with the Job Application Privacy Notice above? *

    I Agree

    Declaration

    I declare that the information contained in this application is complete and correct. I understand that if I have knowingly provided false information, or directly or indirectly canvassed a Trustee or a Senior Manager of Active Tameside in support of my application, I may be disqualified or dismissed after appointment

    Signed:
    Date:

    Monitoring Information

    Please complete the following information. This part of the form will not be sent to members of the selection panel. The information will remain confidential and will be used to provide an overall profiled analysis of candidates applying for employment and to monitor equal opportunities.

    Date of Birth:

    Disability

    The Equality Act 2010 protects disabled people. Under the act, a person is disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.

    Do you consider yourself to have a disability according to the terms given in the Equality Act 2010?

    YesNo

    If you have answered yes, please tick the types of impairment which apply to you below:

    Physical impairment, such as difficulty using your arms or mobility issues which means using a wheelchair or crutches.Sensory impairment, such as being blind/having a serious visual impairment of being deaf/having serious hearing impairment.Mental health condition, such as Depression.Learning disability (such as Down ’s Syndrome or Dyslexia) or cognitive impairment (such as Autism)Long-standing illness or health condition such as Cancer, HIV, Diabetes, Chronic Heart Disease or Epilepsy.

    Other, please give details:

    All applicants who have a disability and who meet the essential criteria for this job will be guaranteed an interview. Obtaining an interview under the guaranteed interview scheme does not guarantee you the job. On completion of the selection process the most suitable candidate will be offered the post.

    Gender

    MaleFemaleNon-BinaryPrefer not to say

    Is your gender identity different to the sex you were assumed at birth?

    YesNoPrefer not to say

    Are you married or in a civil partnership?

    YesNoPrefer not to say

    What is your sexual orientation?

    HeterosexualGay woman/LesbianGay ManBisexualPrefer not to say

    If you prefer to use your own term, please specify here:

    Ethnic group

    Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.

    White

    EnglishWelshScottishNorthern IrishIrishBritishGypsy or Irish TravellerPrefer not to say

    Any other white background, please write in

    Mixed/multiple ethnic groups

    White and Black CaribbeanWhite and Black AfricanWhite and AsianPrefer not to say

    Any other white background, please write in

    Asian/Asian British

    IndianPakistaniBangladeshiChinesePrefer not to say

    Any other Asian background, please write in

    Black/African/Caribbean/Black British

    AfricanCaribbeanPrefer not to say

    Any other Black/African/Caribbean background, please write in

    Other ethnic group

    ArabPrefer not to say

    Any other ethnic group, please write in

    Religion

    No religion or beliefBuddhistChristianHinduJewishMuslimSikhPrefer not to say

    If other religion or belief, please write in

    Criminal Convictions

    Have You Ever Been Convicted Of A Criminal Offence? (Declaration subject to the Rehabilitation of Offenders Act 1974)

    YesNo

    Present Situation

    EmployedTraining / EducationVoluntary WorkUnemployed

    Please give details of your most recent employer

    Company
    Address
    Positon Held
    Current Salary
    Date Employment Started
    Date You Left (If Applicable)

    Previous Work Experience

    Please state the most recent employment first. Please include any voluntary work you may have carried out.

    What Qualifications do you have?

    (Formal Education: Secondary School / College / University)

    Other Related Training

    Details of Course / Qualification etc.

    Are you a Member of a Professional Body?

    YesNo

    Our vision is to be the go-to organisation to conquer inactivity and improve healthy life expectancy.

    We will achieve this through a group of shared values.
    Please explain briefly how you have demonstrated these values in the past.

    Active – we encourage people to be active and healthy
    Champion – we work and adapt so that we can be the best
    Together – we are there for people that need our help
    Integrity – we are genuine and honest with people
    Value – we respect people’s opinions and differences
    Enthusiasm – we enjoy what we do and act positively

    Experience / Skills / Knowledge

    Please support your application by relating to the person specification how you meet the criteria listed. Please could you give examples of how you have met each one. If you wish to use separate sheets please attach to application form. Please do not put your name on this sheet.

    Additional Information

    Please provide the name and address of two employment referees, one of which should be your current employer. (Or most recent employer if unemployed).

    Referee 1

    Full Name
    Job Title
    Address
    Phone Number
    E-mail Address

    Referee 2

    Full Name
    Job Title
    Address
    Phone Number
    E-mail Address

    Driving License

    Do You Hold a Valid Driving License?

    YesNo

    What Type of Driving License Do You Hold?

    ProfessionalFullLGV

    If you are related to a board member or member of staff of Active Tameside you should make us aware of this. Please give details below.

    Active Tameside

    Active Tameside