Job Application Form

Before completing this application form please read the enclosed guidance notes
Job applied for: Post ref:

Surname/Family name: Initials:

Personal Details and Referees
Home Address







Post Code
Telephone:
Home:
Mobile:
Work (if appropriate):
E-mail address:
If you are related to any Members or senior employee of the Council,
please state below his/her name(s) and the relationship. (This does
not prevent such persons from giving as a reference a testimonial of
your ability, experience or character, for submission to the Authority
with your application for employment

References: Please give the name address and telephone number of two independent referees from whom the
Council will seek information regarding your suitability for this job. One of the referees must be your current or most
recent employer.
Name:
Occupation:
Address:


Post Code:
Tel No:
E-mail address:
Can we contact Prior to interview
Please select
Name:
Occupation:
Address:




Post Code:
Tel No:
E-mail address:
Can we contact Prior to interview
Please select


Declaration
I declare that the information on this application form is full, accurate and complete and I understand that if I provide false
information or fail to provide full, complete and accurate information, this may lead to the decision that my application cannot be
considered any further, the withdrawal of offer of appointment, or by my dismissal, without notice, if I have been appointed. I
also understand that canvassing of Members or employees of the Council whether directly or indirectly, will result in this
application being disqualified


Signed: Date:


For Office use only


Job/Career History
Current or last job

Name and address of employer





Tel. number:



Job title:
Date started:
Date left (if applicable):
Current earnings:
Scale or Grade:


Brief details of current or last job:


Previous Jobs

List all employment including unpaid and voluntary work (most recent first)

Dates Employed Employer Name and Address Job or jobs held with employer








Qualifications and Training

Qualification obtained

Type and level (e.g. GCSE, A
Level, Degree etc.)
Date Obtained







Non Qualification Courses and Further Training
Details Date





Are you a member of any Professional Body (please give details)


Driving and Mobility
Do you have a current driving licence Please select
Do you have a current HGV/PSV or other specialist driving licence Please select
Please specify:


The Job and You:

Please provide a detailed statement of the skills, knowledge and experience that makes you suitable for this job.



Data Protection Information
The personal information supplied by you on this application form will be used only to consider your application for
employment with this Council.
If you are shortlisted, contact will be made with the referees you supply on the application form and a confidential
reference will be sought from them.
The information you supply on the Equal Opportunities Monitoring Information Form will be used for those purposes stated
only and will be retained in an anonymised form so that it cannot be linked to individual applicants.
The information you supply will be retained only as long as necessary for the purposes of recruitment and monitoring

Please make sure the correct postage is used and return the completed form to:

Recruitment Services
PO Box 891
Stockton on Tees
TS19 1JT

Or email to: [email protected]






Personal Details
Full Name: Title: Please select Other (please state):
Date of Birth: Age: Gender: Please select

(Optional) Is your gender identity the same as the gender you were assigned at birth? Yes NO

Please state where you saw this job advertised:
Ethnic Origin (Please indicate your ethnic origin clicking on the box will place an X against your selection)
Asian or Asian British

Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background, please specify

Black or Black British

Caribbean
African

Any other Black background, please
specify
Other ethnic groups

Arab
Gypsy/Romany/Irish Traveller

Any other background, please specify


Mixed background

White and Black Caribbean
White and Black African
White and Asian

Any other mixed background, please
specify
White

English
Other British
Irish

Any other white background, please
specify


Religion (mark one box only) (Optional)

Buddhist Christian Hindu Jewish Muslim Sikh None Other Prefer not to say

Sexual Orientation (Mark One box only) (Optional)

Bisexual Gay/Lesbian Heterosexual/Straight Other Prefer not to say

Disability

Stockton on Tees Borough Council is positive about disability and welcomes applications from disabled people. Please answer the
section on disability, which we include to establish whether we need to make adjustments to enable you to take part in the selection
process; take positive action in supporting employment for disabled people; establish whether you will be able to carry out a function
that is intrinsic to the work concerned and / or establish that you have a disability where this is an occupational requirement (Section
60 of the Equality Act 2010 refers). As a Disability Symbol User, the Council undertakes to interview any applicant who declares a
disability as detailed on the Application for Employment and who meets the minimum essential criteria for the job.

Do you have any of the following long-standing conditions?
Deafness or severe hearing impairment
Blindness or severe visual impairment
A condition that substantially limits one or more basic physical activities such as walking, climbing stairs, lifting or carrying.
A learning difficulty
A long-standing psychological or mental health condition
Other, including any long-standing illness
No, I do not have a long-standing condition

Do you have any specific requirements for interview or testing that you wish us to know about? Please give details:


Please ensure you return this form with your completed application form
For Office use only

Recruitment Monitoring Form

Personal Details and References
Please complete this section fully and clearly. This is important contact information.
We need to know if you are related to a Councillor or an employee of the Council. This is t o ensure that you
are neither disadvantaged nor favoured in your application. You must not canvass either a Councillor or
Council employee to gain employment. This will disqualify your application.
Referees must be able to produce information about your suitability for the post. References provided by
relatives, friends or people with whom you live are not acceptable.
You will need to provide the names of two referees. One referee must be your current or most recent
employer. The second referee should be a previous employer or someone who can give information about
you that is relevant to the job. If you are a school or college leaver please give the name of your head teacher
or tutor. Alternatively if you have had a Saturday or other part time job the person you worked for may be
prepared to act as referee.
It is advisable to contact your referees at an early stage to let them know that you wish to give their name and
ensure that they are willing to act as a referee.
If you are shortlisted, contact will be made with the referees you supply on the application form. If, however,
we should not contact a referee prior to interview, please say so on the application form.
No offer of appointment will be made until references, that are satisfactory to the Council, are received.

Job/Career History
Please state your current or last employer's name, address and telephone number in full. Do not go into too
much detail but list the main activities of the job.
In the previous jobs section please account for all time since you left school, college or university. List your
jobs, with the most recent first, stating month and year and mentioning any gaps in employment. Include
voluntary work particularly if you have not been in paid work.

General Issues

Your application will be assessed against the criteria listed on the person specification.

CVs alone are not acceptable. You must complete the application form.
Make sure all sections are completed clearly and as fully as possible.
Make sure your application relates to the person specification.
If you run out of space you may use additional pages.
Make sure your application form is returned by the closing date.
Keep a copy of your application; it will be useful to refer to for preparation if you are called
for interview.
If you have a disability that prevents you from completing the application form please contact
Xentrall Recruitment Services on 01642 526992 or email [email protected] in the first
instance.

Current legislation means that you will be required to provide documentary evidence (for example National
Insurance Number) showing that you are entitled to work in the United Kingdom.

Qualifications and Training

List the qualifications you possess indicating grades.

List any formal, informal or on the job training you have received which you consider relevant to the vacancy.

Some posts require the post holder to be able to travel between locations This does not necessarily mean
use of a car; the actual mode of transport can vary depending on the distance to be travelled. Other posts
may specify that driving is essential. For this reason you are asked to state whether or not you hold a current
driving licence. Please complete this section fully.
The Job and You

This is your opportunity to tell us why you are suitable for the job. Read the job description and person
specification carefully to see what skills and experience you have that relate to those required by the job.
Think about examples you can give to provide evidence of this.
Consider what you have done in the past: at home; at school; at college; in paid work; unpaid work; or in a
hobby.
These may be useful to show how you meet the items on the person specification. For example running a
home can show skills such as organising or budgeting, being active in a club or other groups can show
teamwork, communication or organising skills.
Your completed application form will be used to decide whether or not you progress to the next stage of the
selection process. No assumptions will be made about your experience. It is vital that you have told us how
you meet the selection criteria.
Please do not forget to sign your application form.
Equal Opportunities and Monitoring

Stockton-on-Tees Borough Council values the diversity of the community it serves. We therefore strive to
ensure that our services reflect the needs of all people within the community. All individuals can expect to
receive equal access to employment, promotion and training as well as equal treatment in respect of all the
services delivered by the Council.

This policy is based on the recognition that we live and work in a diverse society in which everyone has
individual abilities and needs.
We are working towards an environment where all employees, residents and service users receive equal
treatment regardless of gender, marital status, family circumstances, sexual orientation, age, disability, race,
colour, religion, ethnic, national or social origin.
We ask you to assist us in monitoring our policies and practices by completing the recruitment monitoring
form.