Please choose the post you are applying for from the drop down list, and click on the 'Confirm' button.

Application for the post of:

Important: This online form cannot be part completed and saved for completion at a later date.



DATA PROTECTION STATEMENT UNDER THE DATA PROTECTION ACT 1998


All the information provided by you in connection with your application for this vacant post will be treated as confidential by the Council's Human Resources Section. Your application form may be copied for use during the recruitment process.

Information given by you in Section 1 Personal Details will be retained by the Human Resources Section and used by them in the event that you need to be contacted during the recruitment process.

Information given by you in Section 2 Equal Opportunities Monitoring will be dealt with separately from the rest of your application. The Equal Opportunities Monitoring information will be retained by the Human Resources Section and put onto a computer database. The information we record will be anonymous and held on the database for 1 year so that year on year comparisons can be made. This will help support any decision to change policies or procedures to ensure that equality of opportunity and treatment is maintained. These computer records will be deleted after one year.

Information given by you in Sections 3 to 7 of the application form will be given to the recruiting officer(s) to enable your skills and abilities to be assessed against those required for the job. Once the recruitment process is completed, your application form will be stored for six months for monitoring and feedback purposes. If, following an interview, you are the successful applicant, relevant information will be taken from your application form, entered on to an employee database and it will also used as part of your personal record.

In terms of the Data Protection Act 1998 you are entitled to know what personal information North Wiltshire District Council holds about you, on payment of a fee of £10. Application should be made to the Team Leader, Human Resources and Payroll, North Wiltshire District Council, Monkton Park, Chippenham, Wiltshire SN15 1ER.

Before you complete your application form, please indicate whether you agree to the District Council using your personal information for the purposes stated above.

If you indicate that you DO NOT AGREE to the use of your personal information for the all purposes identified in the Data Protection Statement, only personal information essential to the recruitment process will be used, as described in the Statement.

I agree
I do not agree

to the use of my personal information for the purposes identified in the Data Protection Statement.


Name:Signature:

Note
You will be asked to sign this form if you are successful in being shortlisted for interview.

North Wiltshire District Council may provide information to other Government Departments on request, for the purposes of the prevention of fraud and to other bodies such as Inland Revenue, Department of Social Security, Health Authorities, who have a duty to protect the public purse.




INFORMATION FOR APPLICANTS


Applicants are assessed for suitability for interview on the basis of the information given by them on the application form, please do not attach a CV. You should complete this form accurately and thoroughly. If you need help to complete the application form, please contact our section Human Resources or ask the Job Centre or a friend or relative for assistance. Please note that there are 7 sections to the application form which need to be completed.

Information given for sections 1, 2 and 3 will be retained by the Council's Human Resources Section.


SECTION 1 PERSONAL DETAILS

Surname/Family Name: First Name(s):
Address:
(if this is a temporary address, please also give your usual address)


Preferred Title:
Post Code: May we contact you at:
Work?
Home?
Email?
Mobile?		.
Yes No
Yes No
Yes No
Yes No
Home Telephone Number: Business/Work Telephone Number:
Mobile Telephone Number:
Email Address:

SECTION 2 EQUAL OPPORTUNITIES MONITORING SECTION


Confidential Information

The District Council operates a policy of Equal Opportunties and monitors how its personnel practices and procedures affect different groups. To assist in the monitoring process, please provide the following information. It will be used for the purposes of helping to identify any changes required to procedures and practices and will also help to ensure that the Council offers job applicants equality of opportunity and treatment.

1. Ethnic Origin (please note that ethnic origin is not a matter of nationality, right of abode in the United Kingdom, or the place or birth)

The Council as an employer has a legal duty to promote race equality and to monitor, by their ethnic groups, all applicants for jobs.

How would you describe your cultural or ethnic origin?
(Categories as defined by the Commission for Racial Equality/Census 2001) (Please tick one box)

White
British
Irish
Other white		Mixed
White and Black Caribbean
White and Black African
White and Asian
Other mixed
Asian or Asian British
Indian
Pakistani
Bangladeshi
Other Asian
Black or Black British
Black Caribbean
Black African
Other Black
Chinese or Other ethnic group
Chinese
Other Ethnic group
Gender:
Date of Birth:
Marital Status:
4. Disability (applicants with disabilities will be invited for interview if the essential criteria are met)


The Disability Discrimination Act 1995 defines a person as having a disability if he/she has 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.

If you have a disability and can offer the skills and experience we consider essential for the job, we will guarantee you an interview.

Do you consider yourself to have a disability as defined above?



If you have any special requirements to assist you with an interview please detail them and we will make the necessary arrangements.



5. Advertisement

Please state where you saw the advertisement for this post, if it was in a newspaper publication, which one?




SECTION 3 EMPLOYMENT HISTORY


Present, or most recent employment if unemployed

Job Title:
Employer's name:
Employer's address:

Present salary or wage: Grade of job: (if known)
Other benefits:
Period of Notice required:
Date appointed: Date employment ended:
Reason for leaving, if applicable


Brief description of duties and responsibilities (Please complete the box below, otherwise your application will be classed as void)



SECTION 4 PREVIOUS EMPLOYMENT


Work Experiences

Please gives details of all other positions held since completing full-time education, or during the last 10 years, whichever is the latest, with the most recent and work back. If there have been any gaps in your employment history during the last 10 years, please give dates and a brief explanation.

Name of Employer:
From:
To:
Salary/Grade:
Reason for Leaving:

Job Title and Brief Description of main duties:



Name of Employer:
From:
To:
Salary/Grade:
Reason for Leaving:

Job Title and Brief Description of main duties:




Name of Employer:
From:
To:
Salary/Grade
Reason for Leaving:
Job Title and Brief Description of main duties:




Name of Employer:
From:
To:
Salary/Grade
Reason for Leaving:
Job Title and Brief Description of main duties:



Name of Employer:
From: To:
Salary/Grade
Reason for Leaving:
Job Title and Brief Description of main duties:





SECTION 5 INFORMATION IN SUPPORT OF YOUR APPLICATION


In the information we have supplied you will find a job description and person specification. Please explain how you meet the job requirements. You may draw on your knowledge, skills, abilities, experiences gained from paid work, unpaid work, education and training. Tell us how you meet the selection criteria for this job, giving examples where possible. Selection for interview will be based on the evidence you provide of your ability to meet the job criteria.





SECTION 6 EDUCATION



Secondary Education (CSE, GCSE, RSA, O and A Levels etc)

Name of School/College:

QualificationSubjectGrade
Further and Higher Education (Degree, Diploma, BTEC, City & Guilds, NVQ etc)


Name of School/College/University:

QualificationSubjectGrade
Technical or Professional Qualification/Membership (including membership of professional bodies)

Qualification/MembershipSubjectQualification/Membership DateGrade
Relevant training and/or personal development (in the last 5 years) - state who provided the training, duration and dates (Examples could include short courses, skills training, external awards/activities etc)





SECTION 7 OTHER INFORMATION


Relationship Disclosure

Are you related to any elected Council Member or Senior Officer at North Wiltshire District Council?


If YES, please give names and state the relationship. Failure to disclose such a relationship will, if the appointing panel so declares, disqualify you from the appointment, and if appointed without disclosure will render you liable to dismissal without notice.

Name:
Relationship:
4. References


Give names, designations and addresses of TWO persons, to whom reference may be made. One should be your present or most recent employer and the other a previous employer. If you are a recent school leaver, one should be the Head Teacher of your last school. If you have been unemployed for at least two years, give the names, designations and addresses of two people who have known you for at least two years. We are unable to accept references from friends or family members. It is the policy of North Wiltshire District Council to seek references only once a provisional offer of employment has been made and accepted.

Referee No. 1

Name: Relationship:
Address:

Referee No. 2

Name: Relationship:
Address:

May we contact your referees if we make a provisional offer of employment to you?

Referee 1:
Referee 2:
Disclosure of Criminal Convictions


Please give details of criminal convictions below. Unless stated otherwise, you do not need to declare convictions which are 'spent', as defined by the Rehabilitation of Offenders Act 1974 and subsequent regulations.

However, if you are applying for a job connected with people from the following list, you must always declare convicitions and/or cautions for criminal offences, even where they are 'spent'. For these purposes, this includes working with children, young and older people, those who are dependant on alcohol or drugs, and those with mental or physical disabilities, illness, injury or deformity, including people who are blind, deaf or without speech.

For certain posts, police checks will be required. If this is necessary, you will be asked to sign a separate authorisation.

Details of criminal convictions:

Have you ever been convicted of a criminal offence?
If yes, please give details (spent convictions need not be disclosed)





Job Sharing

In general, all full time posts can be job shared and applicants will be considered on the same basis as those wishing to work full time.

Are you applying on a job share basis?
If 'Yes' please state preferred employment arrangements
(day/hours)
Driving


If the vacancy Terms and Conditions and Job Specification state that you must either possess a current driving licence and vehicle, or be independently mobile, you are required to confirm whether you meet this requirement by including the relevant information in Section 5 of the application form. You must also give details of any penalties on your licence or convictions pending.

Declaration

To the best of my knowledge the information given on this form is correct. I also understand that if I have omitted or falsified information, it could lead to disqualification of my application, or later my dismissal, if appointed. I confirm that I have not canvassed any elected Member or Senior Officer of North Wiltshire District Council in relation to this appointment.

You will be asked to sign this form if called in for interviewing.


You are applying for the position of . If this is incorrect, then please return to the start of the form and choose the post you are applying for.