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Form CHRIS5 Application for Employment - the University Offices

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Form CHRIS5 Application for Employment - the University OfficesForm,for,the,The,form,THE,Chris

    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 for

    Department

    Vacancy reference

    Applicant reference

     (office use only)

    PART 1

    PERSONAL DETAILS

    Family name

    Given name(s)

    Title Mr / Mrs / Ms / Miss / Dr / Other:

     Current address Post code

    Home telephone

    Mobile telephone

    E-mail address

    Immigration status Are you a British/European Economic Area/Swiss national

    with right to work in the UK?

     Yes No

    If no, do you already have permission to work in the UK?

    Yes No

    If yes, please specify your visa type and visa end date:

UK National Insurance number (where

     held)

    We offer this application form in alternative formats which can be provided by the department to which you are applying.

    CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 1, Page 1 of 5

EDUCATION, QUALIFICATIONS & TRAINING

    GCSE and Equivalent Education

    We do not need full details of your GCSEs (or equivalent qualifications). Please give your total number of GCSEs (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 in a subject that is particularly relevant to or required for this job, or if you have overseas qualifications. Please note that you may be required to produce qualification certificates if you are invited to attend an interview. The total number of GCSEs (or equivalent) I have at Grade A* to C is

    Other details of GCSE and equivalent education

Education Above GCSE Level and Training

    Starting with the most recent, please give details of your education above GCSE 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.

    Place of learning Start End Qualification level Subject Grade (if

    date date (if applicable) applicable)

Professional Body Membership

    Please give details of any professional body membership which you hold.

    Professional body

    Membership level

    Start date

    CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 1, Page 2 of 5

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 End Employer Job title and key responsibilities Reason for

    date date leaving or notice

    period (where

    applicable)

CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 1, Page 3 of 5

SUITABILITY FOR THE ROLE

    Please review the requirements of the role and provide evidence of how you meet these, using specific examples.

    CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 1, Page 4 of 5

REFERENCES

    Please provide details of two people (not relatives or friends) who will each provide an employer’s

    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

    Name

    Position

    Address:

    Telephone number

    E-mail address

    Can we contact this referee before the Yes No interview?

    Second reference

    Name

    Position

    Address

    Telephone number

    E-mail address:

    Can we contact this referee before the Yes No interview?

APPLICANT DECLARATION & DATA CONSENT

    The information you have provided in Part 1 will be used to process your application. It will not be passed to third parties or used for other purposes, other than those stipulated in Parts 2 and 3. If you are successful, we will keep your application form. If you are unsuccessful, we will destroy it twelve months 1after this vacancy closes. Security procedures are in place for protecting your data in accordance with the principles of the Data Protection Act 1998. Your details may be stored electronically in a password-protected system and/or as paper copies in secure storage. Please read the statements below and then sign and date to confirm your acceptance of them.

    ; I have read the above, and I understand and accept how the University will use and store my

    personal data.

    ; 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 and subsequent termination of contract of employment.

    ; I understand that the University of Cambridge may carry out a verification process and may

    check all or any of the information provided on the application form, given in references and

    presented as proof of identity.

    ; I understand that an appointment, if offered, may be subject to a satisfactory medical

    examination and/or satisfactory completion of other pre-employment checks.

    ; If I have been required to submit Part 2 as part of the application process, I understand that the

    University of Cambridge will verify the information given in Part 2, which might include referral

    to an appropriate third party for purposes of security clearance.

    Signature Date

     1 Except if the person appointed to the post is a migrant sponsored under the UK’s points-based immigration system, when we

    would be required to retain the applications of all candidates shortlisted for final interview for one year or until a UK Border

    Agency compliance officer has examined and approved them, whichever is the longer period.

    CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 1, Page 5 of 5

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. 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 ask the department to which you are applying.

    Section A: for applications to security-sensitive positions

    PERSONAL DETAILS

    Maiden name (if applicable)

    Date of birth

    Place of birth

    National Insurance number

    Nationality

    Passport no. and issue date

    Driving licence number

    PERSONAL REFEREES

    Please complete the contact details for two referees who have known you in a personal capacity over the

    last five years.

    First reference

    Name

    Position

    Address

Telephone number

    E-mail address

    How long have they known you?

    In what capacity have they known you?

    Do we have permission to contact this referee Yes No

    before the interview?

CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 2, Page 1 of 3

Second reference

    Name

    Position

    Address

Telephone number

    E-mail address

    How long have they known you?

    In what capacity have they known you?

    Do we have permission to contact this referee Yes No

    before the interview?

    PREVIOUS ADDRESSES

    If you have lived at your current address for less than 5 years, please give details of all addresses for the

    previous five years with dates below. Please continue on additional sheet if required.

    Previous address 1

    Address

    Dates you lived at this address From __/____ to __/____

    Previous address 2

    Address

    Dates you lived at this address From __/____ to __/____

    ADDITIONAL CHECKS

    ; I consent for an external security screening service, if required, to conduct checks necessary to

    progress my application and to provide the results to the University of Cambridge.

     Signature: Date:

    ; I authorise the Driver and Vehicle Licensing Agency to supply any information it holds on its

    driver computer record about my driving entitlement, past and present, to the University or an

    external security screening service. This includes any valid endorsements and disqualifications

    (within the meaning of the Road Traffic Offenders Act 1988) and excludes any medical

    information.

     Signature: Date:

    ; I authorise the United Kingdom Passport Agency to supply any information held in its records

    regarding the details of my passport submitted with this application to the University or an

    external security screening service.

     Signature: Date:

    CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 2, Page 2 of 3

    Section B: for applications to positions which are eligible for a Disclosure and Barring Service check

    Certain positions in the University are exempt from the provisions of the Rehabilitation of Offenders Act 1974. This means that they are eligible for a criminal records check through the Disclosure and Barring Service (DBS). Such positions often involve working with children or adults in regulated activity, or responsibilities concerned with the provision of health services. A full list of positions eligible for DBS checks is found on the Disclosure and Barring Service (DBS) website (https://www.gov.uk/dbs).

    If you have been directed to complete this section of the form, you are applying for a position which is eligible for a DBS check. As a result, you must now disclose any pending criminal proceedings, cautions or convictions against you (spent and unspent) which are not ‘protected’. Protected convictions and

    cautions are normally old and minor; they are not subject to disclosure by the DBS and cannot be taken into account by employers.

    In addition, if the role you are applying for involves working with children or adults in regulated activity, you are required in law to inform us if you have been barred from such employment. The University promotes equality of opportunity for all, as stated in our Equal Opportunities policy. The information which you disclose to us below, and any information arising from a DBS check, will be treated in confidence and will not be used unfairly against you. Pending proceedings, cautions and convictions will not automatically prevent you from being appointed (unless required by law). Information that you disclose to us may be discussed with you further if you reach the short-list stage of the process. Any offer of employment made to you will be conditional upon the relevant type of DBS check being completed to the University’s satisfaction. If you fail to disclose information that is subsequently revealed by a DBS check, this could result in any conditional offer of employment being withdrawn and/or your referral to the DBS. Any information disclosed by a DBS check will be discussed with you.

Do you have any spent or unspent cautions or criminal Yes No

    convictions that are not protected in law?

    If ‘YES’ please provide further information:

    Please note: the filtering rules available at

    https://www.gov.uk/dbs define which

    convictions/cautions are protected.

Do you have any criminal proceedings pending against Yes No

    you?

    If ‘YES’ please provide further information:

Have you been barred from working with children in Yes No

    regulated activity?

    If ‘YES’ please provide further information:

    Please note: you must only answer this question if you

    are applying for a position that involves regulated

    activity with children.

Have you been barred from working with adults in Yes No

    regulated activity?

    If ‘YES’ please provide further information: Please note: you must only answer this question if you

    are applying for a position that involves regulated

    activity with adults.

CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 2, Page 3 of 3

PART 3

    MEDIA AND EQUAL OPPORTUNITIES MONITORING (OPTIONAL)

    The University is an equal opportunities employer and is 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 by the University to generate anonymised statistics that will never be presented in a form that allows individuals to be identified.

    We will record your sensitive personal information on our HR computer system. This system is password-protected and only trained individuals have access to it. Only a limited number of key individuals in Human Resources, Payroll and Management Information Services can view information on disability, ethnic origin and nationality, and they will treat it with the strictest confidence. 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. Where the post you have applied for has a retirement age, we will also use your date of birth to work out your expected date of retirement. If you choose not to provide information on your gender and date of birth now, we will ask you for it again upon appointment. We will record this information on our HR computer system and only a limited number of trained staff in your prospective department will be able to access it, in addition to the staff described in the paragraph above.

    If you are appointed, we have to provide some of the information in this part of the application to the Higher Education Statistics Agency (HESA http://www.hesa.ac.uk/) without your name being

    associated with it.

    Vacancy reference

    Post title

    Applicant reference

     (office use only)

    Advertising Source

    Where did you first

    learn about this

    vacancy?

    Gender

    What is your gender? Female

     Male

     Prefer not to say

    Date of Birth

    What is your date of __/__/____ birth?

     Prefer not to say

CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 3, Page 1 of 3

Nationality

    Which country defines Country: your national identity?

     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 the University thinks that they are the most appropriate.

    What is your White: background? British

     Irish

     White background other

    Mixed:

     White and Black Caribbean

     White and Black African

     White and Asian

     Mixed background other

    Asian or Asian British:

     Indian

     Pakistani

     Bangladeshi

     Asian background other

    Black or Black British:

     Caribbean

     African

     Black background other

    Chinese:

     Chinese

    Arab

     Arab

    Gypsy or Traveller

     Gypsy or Traveller

    Other ethnic group:

     Other ethnic group

    Prefer not to say:

     Prefer not to say

CHRIS/5, Version 6, 2013-6-21 University of Cambridge Application for Employment Part 3, Page 2 of 3

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