CONFIDENTIA
School Non-Teaching Application Form
Please note that CVs cannot be accepted
ase complete ALL Sections of this form as appropriate, and for ease of photocopying, complete in Type or Black
Please note sections 1, 2 & 3 of this application form will be removed prior to shortlisting.
urn the completed form to:
OFFICE
Job title: Application no: USE ONLY
Do you currently work for Sandwell
Reference no: Metropolitan Borough Council? Yes No
Are you on the At Risk Register for
Closing date: Sandwell Council or Sandwell Leisure Trust?
Yes No
Section 1: Personal Details
Title: Day/Work Telephone:
First name(s): E-Mail Address:
Last Name: Date of birth:
Former name(s): NI Number:
Home Address: Details of person to contact in an emergency
Name &
Address:
Postcode: Postcode:
Home Telephone: Emergency Telephone:
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Section 2: Equal Opportunities
As part of our equal opportunities policy we request that you complete the following
information. This information is used for monitoring purposes only. All information will
be treated as confidential and will not be used when shortlisting or deciding on whether
an applicant is successful or unsuccessful in obtaining employment. The information
you provide will help us to ensure that our recruitment procedures are fair by allowing
us to identify and eliminate potential areas of discrimination.
Ethnic Origin
Prefer not to say Any other ethnic group (not listed)
Asian or Asian British - Bangladeshi Asian or Asian British - Chinese
Asian or Asian British - Indian Asian or Asian British - Other
Asian or Asian British - Pakistani Black or Black British - African
Black or Black British - Caribbean Black or Black British - Other
Mixed Ethnic - White & Asian Mixed Ethnic - White & Black African
Mixed Ethnic - White & Black Caribbean Mixed Ethnic Group - Other
Other Ethnic Group - Arab White - Gypsy or Irish Traveller
White - Irish White - Other
White - Welsh/English/Scottish/N.Ireland
Other Ethnic Group/comments
Religion/Belief
Buddhist Hindu Muslim Other Christian Jewish None
Sikh Prefer not to say
Disability
The Equality Act (2010) defines a disabled person as someone with a physical or mental
impairment which has a substantial and long-term adverse effect on his/her ability to carry out
normal day-to-day activities.
Do you consider yourself to have such a disability?
Yes No
Disability Category
Hearing Impairment Learning difficulties
Learning Disability Mental Health Condition
continued on Page 3
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Neurological condition Mobility impairment
Physical co-ordination difficulties Other
Reduced physical capacity Physical impairment
Speech impairment Sensory impairment
Prefer not to say None
Visual impairment (not corrected Long-standing illness or health condition
by spectacles or contact lenses)
Please identify any special requirements, adjustments or equipment which may assist you
in the recruitment process
to enable you to carry out the job
Gender
Female Male
Prefer not to say
Age Range
16 - 17 18 - 24
25 - 29 30 - 39
40 - 49 50 - 59
60 - 64 65+
Sexual Orientation
Bisexual Gay man
Heterosexual/straight Prefer not to say
Lesbian/Gay woman
To the best of your knowledge, are you related to any Council Member and/or to
any employee of Sandwell Metropolitan Borough Council? If so, please explain:
Do you have a legal right to live and work in the UK? YesNo
I declare that, to the best of my knowledge and belief, the information I have provided is true. I unde
Signed Date
PLEASE NOTE SECTIONS 1 & 2 OF THIS APPLICATION FORM WILL BE REMOVED PRIOR TO
SHORTLISTING
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OFFICE
Job title: Application no: USE ONLY
Reference no:
Section 3: Education, Training & Qualifications
Secondary/Further
Date
School/College/University Examination Results
From To (Name & Address) (Subject, Level and Grade)
Mth/Yr Mth/Yr
Academic/Professional
Date
College/University Examination Results
From To (Name & Address) (Subject, Level and Grade)
Mth/Yr Mth/Yr
Relevant training (including short, in-service training)
Date
College/University/Training Provider
From To Course Title/Results
(Name & Address)
Mth/Yr Mth/Yr
Other qualifications, membership of professional bodies
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Section 4: Experience
Please complete the following, starting with your current employment and include all
employment. Any employment with temporary work agencies must show the agency as
the employer as well as the business where the work was carried out. Please also
include any breaks in employment history together with the reason for the break. Please
complete the following accurately and include all experience since the age of 16, or
since leaving full time education.
Current job/post title:
Name & address of employer:
Salary/wage: Grade/scale:
How long have you worked/ From: To:
did you work there? Please state number of years:
Do you still work there: Yes No
If YES, period of notice required?
If NO, reason for leaving
Briefly describe your duties:
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Date Employers name & address or Reason for
your activity if you are/were Position held leaving/break in
From To
not employed employment
Mth/Yr Mth/Yr
Please continue onto a separate sheet if necessary.
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Section 5: Supporting Information
Please use this page to outline any other information that may help your application.
Continue onto a separate page if necessary.
Please continue onto a separate sheet if necessary.
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Section 6: Convictions / Online Searches
Self-declaration of suitability to work in posts requiring a Disclosure and Barring Service
Check
The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013
and 2020) provides that when applying for certain jobs and activities, certain convictions and
cautions are considered ‘protected’. This means that they do not need to be disclosed to
employers, and if they are disclosed, employers cannot take them into account.
Should you be shortlisted for interview you will be asked to declare on a separate form
whether you have any convictions or cautions that are not “protected” in line with this
legislation. Further information on the filtering of these cautions and convictions can be found
in the DBS filtering guide.
It is an offence to apply for a position working with children if you are knowingly barred.
Online Checks
In line with the Statutory Guidance Keeping Children Safe in Education, an online check will be
undertaken for all shortlisted candidates prior to the interview.
Someone who is not on the interview panel will undertake this search and only share
information obtained with the panel should this have potential implications around your
suitability to work with children.
The panel may ask you specific questions about any information obtained via this online
search if appropriate at interview.
All information given/obtained will be treated as strictly confidential and will be stored securely.
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Section 7: References
Please provide details below of two referees (one of whom must be your present or most
recent employer) who are able to comment on your suitability for the position:
Name: Name:
Address: Address:
Postcode: Postcode:
Telephone no: Telephone no:
E-Mail address: E-Mail address:
Occupation: Occupation:
If you have previously been employed by Sandwell Council, the unit in which you worked will
be asked to confirm details of your employment, including the reason for your leaving.
May we contact your current employer at this stage without further reference to you?
Yes No
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Section 8: Data Protection Act
The information you are providing will be used by Sandwell Metropolitan Borough
Council in connection with your application and for assessing your suitability for the
post advertised. The information will be shared only in compliance with the law and
for the purpose of monitoring
the Council’s practices to ensure equality of opportunity.
If I am appointed to work with Sandwell MBC, I give my permission for my name
and contact details to be provided to the recognised Trade Unions in Sandwell
(please tick as applicable).
Yes No
Section 9: How did you find out about this vacancy?
Please indicate where you first saw information about this vacancy.
Job Centre Fish 4 Jobs Website
Local Newspaper Regional Website wmjobs.co.uk
National Newspaper From Friend or Colleague
Specialised Publication Sandwell’s Jobs Opportunity Bulletin
Sandwell’s Jobs Website Other, please specify
Monster’s Jobs Website
N.B. Canvassing for this appointment will disqualify your application.
Please check that all sections of this form have been completed and and if
returning by post, that you have signed the declaration on the bottom on page
3. If you e-mail this form you will be asked to sign the form if you are
interviewed.
P.18/Schools Rev. 06.21
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