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Job application formIncluding guidance notesHelpful tips Please read through the guidance notes before completing your application form. Complete the PDF application form, you may only type in the allowed fields. All sections of the application form must be completed. If you have any further questions regarding the application form or the recruitment processthen visit our FAQ pages at http://www.cumbria.gov.uk/jobsandcareers All sections of the application form must be completed. Please note that DBS checks will be completed for posts which require them and additionalapplicant declarations will be required for posts covered by the Disqualification under theChildcare Act (including Disqualification by Association) legislation. (Further details areavailable in the guidance for completing the application form).6HFWLRQ Your DetailsTitle:Forename(s):Surname:Post for which you are applying:Post reference number:Where did you see the post advertised?Are you an internal applicant?YesNoAre you on the AEP? (Internal applicants only)YesNoAre you working with CCC through an agency?YesNoServing the people of Cumbriacumbria.gov.uk

Cumbria County CouncilGuidance notesThe following notes will assist you in completing the application form.Your personal detailsRelationship: Canvassing directly or indirectly will automatically disqualify you from the recruitmentprocess.The information provided on this application may be stored and processed by Cumbria CountyCouncil for a period of four months for recruitment purposes and if successful the information willbe stored on personal file and processed for the purpose of the employment relationship.Applicants with disabilities: Cumbria County Council is a Positive about Disabled Employer. If adisabled applicant meets the essential criteria for the post they will automatically be invited forinterview. Under the Equality Act 2010, a person has a disability if they have a physical or mentalimpairment which has a substantial and long-term effect on their ability to carry out normal day today activities.Supporting informationThe information you provide in this section will be used when shortlisting applications for interviewso it is very important that you provide as much information as possible to clearly show how youmeet the essential and desirable requirements detailed in the post specification. If you run out ofspace you can attach additional sheets to your application. Please ensure these are signed anddated.Your employment historyAll applicants must complete this section, giving details of their employment history for the past 10years leaving no periods of time unaccounted for. In addition, applicants may provide details whereexperience gained more than 10 years ago is relevant to the post being applied for. Indication oftime off for a career break, for caring responsibilities, for study, travel or absences from work owingto a disability will not prejudice your application. Please attach additional sheets if necessary.QualificationsIf successful in your application you will be required to provide original documentation ofqualifications. Photocopies are not acceptable.Your professional membership detailsPlease complete this section if you hold any professional memberships which are relevant to thepost for which you are applying. Where applicants are applying for a teaching post they mustcomplete the information in this section on their DFES status.ReferencesExternal applicants must provide details of two referees. One must be your current or most recentemployer and the other may be a previous employer or a character reference. Where possible thetwo referees must be from separate sources and not the same organisation or employer. In thecase of school leavers a reference should be from your Head Teacher. All referees should haveknown you for at least one year or more and cannot be from a spouse, partner, friend or relation. Ifsuccessful in your application references will be requested so please ensure you have thereferee’s permission to provide their details on your application form. Internal applicants who havemore than a years’ service with Cumbria County Council need only provide one referee whom theyhave known for a year or more. This cannot be your line manager where they are part of theinterview panel for the post for which you are applying. Internal applicants applying for a job in achildren’s home will still require two references for safeguarding and inspection purposes.Page 2

Right to work in the UKThe Asylum and Immigration Act 1996 makes it a criminal offence for Cumbria County Council toemploy any persons who do not have the right to live and work in the United Kingdom.All British citizens must complete their national insurance details. If you are a non-British citizen,but have the right to live and work in the United Kingdom please ensure you complete the sectionson work permits and/or visas and national insurance number (if applicable).If successful in your application you will be required to provide documentary evidence of your rightto live and work in the United Kingdom prior to commencing employment with the council.DeclarationAll applicants must ensure they sign the declaration to certify that the information provided on theapplication is correct and that they have read and understood the conditions of their application.Any applications received where the declaration has not been signed will be returned to theapplicant.Equality and diversityCumbria County Council is an equal opportunities employer and actively welcomes jobapplications from all sections of the community. No job applicant will be treated less favourablybecause of his or her gender, race, colour, ethnic origin, age, marital status, disability, religion orbelief, sexual orientation or by any other condition or requirement that cannot be shown to bejustified.The information you disclose on this part of your application form will be used for monitoringpurposes only. Through monitoring Cumbria County Council is aware of the make-up of employeesand can then focus support and guidance where best needed.This section of the form will be separated from the job application form on receipt. The informationdisclosed in this section will not form part of the recruitment or selection process and the interviewpanel will not see this part of your form.Page 3

Cumbria County Council6HFWLRQ Guaranteed Interview SchemeCumbria County Council offers a guaranteed interview scheme to the following applicants: Those who consider themselves disabled as defined by the Equality Act 2010Those in care or have left care and are aged 24 and underArmed forces veterans whose last long term substantive employer was the armedforcesIf you meet one or more of the criteria above, and wish to be considered for this scheme, aguaranteed interview will be offered so long as your application can demonstrate you meetthe essential criteria for the role. If you wish to be considered for the guaranteed interviewscheme, please indicate which criteria you meet below:Are you in care, or a care leaver?YesNoDo you consider yourself disabled?YesNoAre you an Armed Forces Veteran?YesNoSection . Your Personal Details &RQWLQXHGAddress:Correspondence Address: (if different)Postcode:Postcode:Telephone:Email:Have you been known by a different name or changed your name byDeed Poll?YesNoYesNoIf yes, provide details:Are you related to any member or employee of Cumbria County Council?If yes, state whether a member of the council, or if an employee, their name, occupation andyour relationship to them.Do you have any convictions, cautions, reprimands or final warnings thatDUe not spent or protected as defined by the Rehabilitation of OffendersAct 1974 ([FHSWLRQV 2UGHU DV DPHQGHG LQ ?YesNo DD Page 4

If you are applying for a post which is exempt from the provisions of the Rehabilitation ofOffenders Act 1974 (e.g. post that require a DBS certificate) you are required to statewhether you have any convictions of criminal charges or summonses pending whether or notyour conviction is regarded as ‘spent’.Further details DUH DYDLODEOH LQ WKH JXLGDQFH IRU FRPSOHWLQJ WKH DSSOLFDWLRQ IRUP If yes, provide details:Section . Supporting InformationMaking reference to the person specification use the space below to tell us aspects related tothe post for which you are applying. Please attach additional sheets if necessaryRelevant experience:Page 5

Cumbria County CouncilRelevant experience, knowledge and skillsSection . Your Employment HistoryProvide details of your employment and account for any periods you were not in work.For example career break, volunteering or education.Current / Most Recent:EmployerAddress:Job Title:Date From:Date To:Salary:Notice Required:Reason for Leaving:Description of DutiesPage 6

Previous Employer:Address:Job Title:Date From:Date To:Salary:Notice Required:Reason for Leaving:Description of DutiesPrevious Employer:Address:Job Title:Date From:Date To:Salary:Notice Required:Reason for Leaving:Description of DutiesPage 7

Cumbria County CouncilSection . Your QualificationsUse the space below to tell us about the qualifications you hold or are working towards whichare related to the post for which you are applying.EstablishmentDates AttendedExamining BodySubjectSection . Your Professional Membership DetailsProfessional Body:Membership Status:Membership Number:Date Attained:Expiry Date:Teaching Applications OnlyDate gained qualified teacher status:Probation Induction Completed:DFES Number:Page 8

Section . ReferencesPlease note if this vacancy is in scope of the recruitment practices outlined in the KeepingChildren Safe in Education guidance, your references will be contacted prior to interview. Thisapplies to those roles based in an education setting such as a school or college.For all other vacancies, references will only be requested prior to an unconditional offer ofemployment, unless you are informed otherwise.Name:Name:Job Title:Job Title:Email Address:Email Address:Address / Contact Details:Address / Contact Details:Relationship to Referee:Relationship to Referee:How long have you known them for?How long have you known them for?Employment or Character Reference?Employment or Character Reference?Section . Right to work in the United KingdomVisaReference:Issued Date:Expiry Date:Work Permit Number:Expiry Date:Residency Permit Number:Expiry Date:National Insurance Number:Page 9

Cumbria County CouncilSection . DeclarationTo the best of my knowledge I declare that the information contained in this application formis accurate and correct.I understand and agree that:a) The provision of false information may result in disqualification from the recruitmentprocess or termination of employment.b) The information provided on this application may be stored and processed by CumbriaCounty Council for a period of four months for recruitment purposes and if successful theinformation will be stored on personal file and processed for the purpose of the employmentrelationship.c) Where I cannot provide evidence of qualifications, suitable references and/or the rightto live and work in the United Kingdom the offer of employment may be rescindedand/or employment terminated.d) Canvassing of Officers or Members of the County Council or any Committee, directlyor indirectly for any appointment will disqualify my application.e) Where the post I am applying for is subject to Rehabilitations of OffendersExceptions Order, failure to disclose any unspent of spent convictions or cautions(which are not protected) will result in non-appointment or disciplinary action andpotential dismissal.f) Where the post for which I am applying requires a background check, I hereby agree tothe relevant check being made by the relevant organisation about the existence andcontent of a criminal records spent or otherwise.g) All information contained in this form will be treated as strictly confidential, and used onlyfor recruitment purposes. By supplying information, you are indicating your consent tothe information being processed for all employment purposes as defined in the DataProtection Act 1998, and any verification checks that may be made.h) Cumbria County Council must protect the public funds we handle and so we may use theinformation you have provided on this form to prevent and detect fraud. We may alsoshare this information, for the same purposes, with other organisations, which handlepublic funds.i) The council does not acknowledge receipt of application forms unless accompanied bya stamped addressed envelope.Signature:Date:Page 10

Section 11. Equality and DiversityThe information you provide here will not form part of the recruitment and selection processand will not be seen by the short-listing panel.Post Details:Reference:Title:Advertised in:Gender:Legal Gender:Genderidentifier:MaleFemaleDecline to specifyMaleFemaleNon binary /Third genderSelf-describeDecline to specifyEthnic Origin:Please tick the Africanbox that youfeel bestCaribbeandescribes yourethnic originIndianArabBangladeshiChineseGypsy and RomaOther AsianOther BlackOther CategoryOther MixedOther WhitePakistaniTraveller-IrishHeritageWhite and AsianWhite-BritishWhite-IrishWhite and BlackAfricanWhite and BlackCaribbeanDecline to specify16-2425-3435-4445-5960-7475 Age:Decline to specifyEmployment:Are you currently in paid employment?YesNoDecline to specifyWith Cumbria County Council?YesNoDecline to specifyPage 11

Cumbria County CouncilReligion and Belief:Please tick the Agnosticbox that youfeel bestBuddhist-Hinayanadescribes yourReligion ReformedMuslimNo l Orientation:HeterosexualSelf-DescribeGay / LesbianBisexualUndeclared / Declined to specifyApplicants with disabilitiesCumbria County Council is a Positive about Disabled Employer. Under the Equality Act 2010,a person has a disability if they have a physical or mental impairment which has a substantialand long-term effect on their ability to carry out normal day to day activities.Do you consider yourself to be disabled under the Equality Act 2010?YesNoPage 12

Please read through the guidance notes before completing your application form. Complete the PDF application form, you may only type in the allowed fields. All sections of the application form must be completed. If you have any further questions regarding the application form or the recruitment process

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