Confidential

Application for Appointment

Before completing this application form,
please read these notes fully to prevent loss of relevant
information upon submission by e-mail.
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will not therefore be used during the selection process.

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 Confidential

Application for Appointment

Please ensure that all fields on this form are completed.
Stoke on Trent College is committed to the principle of equal opportunity in employment, education and
training.
The College will do everything it reasonably can to ensure that no employee, applicant for employment or
student receives less favourable treatment on any grounds which cannot be seen to be justified in relation to
employment, education or training.
Details included on this detachable sheet are kept separate from the remainder of the application while
shortlisting takes place and are used to monitor our procedures & practices in relation to our Equal
Opportunities Policy.
Any separate CV that is enclosed with this application will not be used during the selection process.
Please do not send or attach separate CVs to your e-mail when you return this document

Post Title: Faculty/Directorate: Post No:

SECURITY SUPPORT OFFICER

Surname: Title:
(BLOCK CAPITALS) MR
BOWERS

First Names
(BLOCK CAPITALS)
ASHLEIGH DEAN

Home Address (BLOCK CAPITALS) : Date of Birth: 18/10/1990

8 BANKFIELD ROAD
MEIR Home Telephone Number: 01782 595025
STOKE ON TRENT
ST3 5NH
Work Telephone Number:
(if you can be contacted there)
Gender: MALE

E-mail Address: ASH.BOWERS@HOTMAIL.CO.UK

Is your current employment full time or part time? __________FULL_________

What is your Ethnic Group? A – White B – Mixed

_X__ British ___ White and Black Caribbean
Choose one section from A to E ___ Irish ___ White and Black African
then put an X next to the ___ Any other White background ___ White and Asian
description indicating your cultural (type below) ___ Any other Mixed background
background (type below)

C – Asian or Asian British D – Black or Black British E – Chinese/other ethnic group

___ Indian ___ Caribbean ___ Chinese
___ Pakistani ___ African ___ Any other
___ Bangladeshi ___ Any other Black background (type below)
Any other Asian background (type below)
(type below)

Sexual Orientation Religious Belief/Faith

___ Bisexual ___ Buddhist ___ Christian (state denomination of you wish)
___ Gay/Lesbian
_X__ Heterosexual ___Hindu ___Jewish ___Muslim ___Sikh _X__None
___ Prefer not to say
___ Other (please state ) ___Prefer not to say

For Office Assigned

Use Only Candidate Number:
 The Disability Discrimination Act 1995 defines ‘disability’ and ‘disabled person’ to refer to any person having a
physical or mental impairment which has a substantial and long term effect on his/her ability to
carry out normal day to day activities.

Under this definition do you consider yourself to be disabled? NO

If yes, please specify the nature of the disability here:

Are there any adjustments that the College would need to make to help you for the purpose of:
This entry box The Interview
will accept 10
lines of text
NONE

This entry box The Job

will accept 10
lines of text
NONE

Please indicate preferred method for us to contact you regarding interviews (Post or Email): _EMAIL____

Details of Conviction for Any Offence

The job description supplied with this application will specify if the post you are applying for is exempt from the
rehabilitation of Offenders Act 1974 (Exceptions Order 1975).
If the position you are applying for is exempt from the above Act you should declare all spent and unspent
convictions including any cautions, reprimands or warnings. The appointed candidate will be subject to the
necessary check by the Criminal Records Bureau. Please note that having a criminal record will not necessarily
bar you from working with us.

Date Place and description of court offence with which charged Result

Please state where you saw this vacancy advertised:

THE SENTINEL JOBS SITE

 Data Protection Declaration
The College needs to keep and process certain amount of information about its employees and potential
employees.
In doing so the College will comply with the Data Protection Act 1998.

The information may be used for the following purposes:

• Administration of pay and payroll functions
• Administration of sick pay and sick leave schemes
• Managing the absence policy
• Check suitability and fitness to work at the College
• Administration of the College and statutory maternity leave and pay schemes
• Managing and maintaining a safe College environment
• Managing duties and obligations under the Disability Discrimination Act

I give my consent to the College processing and recording information about me in the following
categories:
• Race and ethnic origin
• Physical or mental health or mental condition
• Criminal records

I understand that this information will be used only for the purpose set out above, and consent is conditional
upon the College complying with its obligation and duties under the Data Protection Act 1998

I accept these terms: Date:

A.BOWERS 10/02/2011

Declaration
I declare that the information given in this application form and any additional information I enclose is true and
complete.
I understand that any false information given, or relevant information omitted, that I would affect this
application may result in my dismissal if appointed. I have not canvassed either directly or indirectly any
member of the Board of Governors or employee of Stoke on Trent College and I will not do so.

I accept these terms: Date:

A.BOWERS 10/02/2011
 For Post Title:
Office Candidate No:
Use Name:
Only Tel. No.:

Present Appointment (if appropriate)

This entry box Name and Address of Employer: (please include Post Code)
will accept 7
lines of text
TK MAXX
LYMEDALE INDUSTRIAL ESTATE
CHESTERTON

Post Code ST5 9QH

Nature of Business:
DISTRIBUTION

This entry box Post held and brief details of responsibilities:

will accept 7
lines of text
WAREHOUSE ASSOCIATE – UNLOADING CONTAINERS, TICKETING ITEMS, SELECTING PRODUCTS, AND
GENERAL WAREHOUSE DUTIES.

Date of Appointment: Salary per annum:

07/2010 14,000

Other Benefits:
20 DAYS HOLIDAY, 10% DISCOUNT

Notice Required: Is your current employment contract permanent?

1 WEEK YES

References
Name & Address of two persons to whom reference may be made,
one of whom should be your present employer (or last employer if you are not currently employed)

Name: WAYNE COBDEN Office Use Only

Requested Received
Position/relationship to you:
EX MANAGER
Address:
KFC
HANLEY
Telephone Number: 01782 07545573799
Email Address:
Can we contact this person?
YES

Name: JAMIE MURINAS

Position/relationship to you:
MANAGER
Address:

TK MAXX
CHESTERTON
Telephone Number: 01782 578700
Email Address:
Can we contact this person? YES

If you DO NOT wish a reference to be sought until you give your permission please answer NO to the last
questions in this selection.
References will normally be taken immediately in respect of candidates selected for interview.
Previous Appointments (Most recent 1st)
Dates: Employer’s Post Held Reason
From To: Name and Address (with grade if appropriate) for Leaving

07\06 11/06 BRADFORD EXCHANGE WAREHOUSE OPERATIVE COLLEGE

STOKE

07\08 07\10 KFC TEAM MEMBER HOURS AND PAY

07/10 CURRENT TK MAXX WAREHOUSE ASSOCIATE WANT NEW

EXPERIANCES, ALSO THE
SHIFTS ARE TERRIBLE

Please give details of any gaps in your employment history:

JUST WHEN I WAS A COLLEGE, I COULD NOT GET A PART TIME JOB.

Education and Qualifications

(Where applicable, please include details of examinations which have been, or are about to be, taken, but results of which are not available.

Secondary, Further Education & Higher (Most recent 1st)

Name of Institution Qualifications Gained Subject: Grade/
(e.g., GCSE) Class
CHESTERTON HIGH GCSE ENGLISH CC
MATHS C
SCIENCE CC
FRENCH C
ART C
GRAPHICS C

GNVQ ICT PASS

NEWCASTLE A/S LEVEL BUSINESS STUDIES D

COLLEGE

FENTON COLLEGE A/S LEVEL LAW E

PSYCHOLOGY E
BIOLOGY E
 Membership of Professional Institutions/Societies
Admission Name of Class of By Examination
Date: Institution Membership Y/N

Supporting Information
This entry box Please give details of your experience, qualifications, skills and knowledge that you consider are relevant to the
will accept 44 post for which you are applying, with reference to the job description and person specification supplied.
lines of text
Please continue on the single sheet appended to the end of this document if necessary.

I HAVE ONLY HAD 3 JOBS SINCE I WAS 16, AND NONE OF THEM REALLY HAVE ANY EXPERIENCE I CAN BRING
TO THIS POSITION. HOWEVER, I AM AN EXTREMELY FAST LEARNER AND CAN ADAPT WELL TO ANY
SITUATION. I SPENT 3 YEARS AT COLLEGE, SO KNOW WHAT IT IS LIKE ON SITE, I THINK THAT THIS COULD
BENEFIT ME IN THIS POSITION. I BELIEVE I WOULD BE AN EXCELLENT ADDITION TO YOUR TEAM.

If you fill this box and need more space, move to the page at the end of this document and continue to type there
 Training (for example Short Courses, Vocational & Professional Courses)
Date: Name of Institution Title & Nature of Course

Details of Leisure Activities

This entry box Please give brief details of your principal leisure interests, including any voluntary work which you may
will accept 14 undertake.
lines of text

I LOVE TO PLAY AND WATCH FOOTBALL, BUT MY PASSION IS MUSIC. I REGUARLY TRAVEL AROUND THE
COUNTRY TO ATTEND GIGS.

Do you possess a current UK Driving Licence? NO Do you own a car/ NO

have daily access to a vehicle?

Health
This entry box Please give brief details of absences due to sickness in the last two years. Please indicate duration and
will accept 12 reason for absence
lines of text
This entry box
Supporting Information: Continuation Sheet
will accept 48 Please continue here if you require more space.
lines of text