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
Title	Mr / Mrs / Ms / Miss / Dr / Other:	
Given name(s)		
Family name		
Current address

Post code	

Primary telephone		
Secondary telephone		
E-mail address		
Immigration status	Are you a settled worker (i.e. do you have the permanent right to work in the UK – for example as a British or EEA citizen)?
Yes       No 
If no, do you already have temporary 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.

REDEPLOYMENT
a)	Are you a current employee of the academic University (this does not include colleges, CUPA)?	Yes        No    	
If your answer to a) was ‘Yes’
b)	Are you considered a priority candidate, as per the Redeployment Framework?	Yes        No    	
If your answer to b) was ‘Yes’, please answer questions c), d) and e): 

c)	Which of the following applies to your situation?		At risk of redundancy whilst on maternity, adoption or shared parental leave	
		At risk of redundancy due to organisational change (with 2 or more years’ continuous service)  	
		At risk of redundancy due to the end of a fixed-term contract within the next 20 weeks (with 2 or more years’ continuous service)  	
		Following formal recommendation in consultation with Occupational Health   	
		Formally recommended for redeployment as a result of a formal procedure (e.g. grievance).	
		None of the above	
d)	Please confirm your current Department, Faculty or Institution:		
e)	Please confirm your current grade:		

EDUCATION, QUALIFICATIONS & TRAINING
Education below degree level
We do not need full details of your GCSEs and A-Levels (or equivalent qualifications). Please give your total number of GCSEs and A-Levels (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 or A-Level in a subject that is relevant to this job, if you have AS-Levels or if you have overseas qualifications.
The total number of GCSEs (or equivalent) I have at Grade A* to C is		
The total number of A-Levels (or equivalent) I have at Grade A* to C is		
Other details of education below degree level	

	
Education at or above Degree Level and Training
Starting with the most recent, please give details of your education at or above degree 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.
Subject	Qualification level (if applicable)	Grade (if applicable)	Place of learning	Start date	End 
date	

			

			

Professional Body Membership
Please give details of any professional body membership which you hold.
Professional body		
Membership level		
Start date		

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 date	End 
date	Employer	Job title and key responsibilities
	Reason for leaving or notice period (where applicable) 	

					

SUITABILITY FOR THE ROLE
Please review the requirements of the role and provide evidence of how you meet these, using specific examples. It is often helpful to deal with each requirement under a separate heading. Please do not change the font size used below or type more than three sides (or write more than the equivalent by hand).

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		
May we contact this referee during the recruitment process and before any offer of employment has been made to you? 	Yes    No 	
Second reference
Name		
Position		
Address		
Telephone number		
E-mail address:		
May we contact this referee during the recruitment process and before any offer of employment has been made to you?	Yes    No 	

Request for reasonable adjustments to the selection process
We welcome applications from individuals with disabilities and are committed to ensuring fair treatment throughout the recruitment process. We will make adjustments to enable applicants to compete to the best of their ability wherever it is reasonable to do so, and, if successful, to assist them during their employment. We encourage applicants to declare their disabilities in order that any special arrangements, particularly for the selection process, can be accommodated. Applicants or employees can declare a disability at any time. 

If you wish to do so, please enter any reasonable adjustments connected with a disability which you require to be made to the selection process in the box below. If, however, you would prefer to discuss any special arrangements with us, please contact the person specified in the job advert or Further Information document as the point of contact for this vacancy. Alternatively, you may contact the HR Business Manager for the department which you are applying to via hrenquiries@admin.cam.ac.uk

APPLICANT DECLARATION
Please read the statements below and then sign and date to confirm your acceptance of them.

•	I understand how the University will use and store my personal data, having read the section on Applicant Data on the University’s HR web pages.
•	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 / withdrawal of any offer of employment made to me. 
•	I understand that the University may check all or any of the information provided as part of my application or given in references.
•	I understand that an appointment, if offered, will be subject to the receipt of references, and the outcome of any relevant pre-employment checks, which the University regards as satisfactory.

Signature						  Date 			    

	
	
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 in the advert or Further Information document for the vacancy. 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 positions which are eligible for a security check
By making this application, I confirm that:

•	I understand that any offer of employment from the University of Cambridge for this security-sensitive position will be conditional upon the satisfactory outcome of security screening checks that are required for, and relevant to, the appointment. 

•	If I receive a conditional offer of employment for this position, I will consent to undergoing required security screening checks, conducted by the University and/or a third party external security screening service acting on behalf of the University. 

•	I agree that my name, telephone number and email address may be provided to a third party external security screening service acting on behalf of the University once I have accepted any conditional offer of employment for this position so that they may contact me to initiate the screening process.

•	If applicable, I have provided any details regarding my background and security matters that I believe the University should be aware of in the box below.

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

You are applying for a job which is exempt from the provisions of the Rehabilitation of Offenders Act 1974. This means that we will conduct a criminal records check on the successful applicant through the Disclosure and Barring Service (DBS – https://www.gov.uk/government/organisations/disclosure-and-barring-service).

You must now disclose any pending criminal proceedings, cautions or convictions against you (spent and unspent) which are not “protected”. Protected matters – usually old, minor cautions and convictions – will be filtered out when the DBS responds to our request for a check and you need not disclose them. The DBS has guidance on which cautions/convictions are subject to filtering: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/240164/Filtering_guidance_v1_5.pdf. 

If the role you are applying for involves working with children or adults in regulated activity, the law requires that you must also inform us if you have been barred from such employment.

If you do not disclose now something that is revealed by the DBS check then we may withdraw any conditional offer we have made (or dismiss you if you have begun employment), and we may report you to the DBS. 

We will treat the information you provide to us here confidentially and it will not be used unfairly against you. Nothing you declare here will automatically prevent you from being appointed (unless required by law). We may wish to discuss it with you if you are invited to interview. Any information revealed through the DBS check will also be discussed with you.

Do you have any spent or unspent cautions or criminal convictions that are not protected in law?
Please note: the filtering rules available at https://www.gov.uk/dbs define which convictions/cautions are protected.
	Yes    No  

If ‘YES’ please provide further information:	
Do you have any criminal proceedings pending against you?   
	Yes    No  

If ‘YES’ please provide further information:

	
Have you been barred from working with children in regulated activity?
Please note: you must only answer this question if you are applying for a position that involves regulated activity with children.	Yes    No  

If ‘YES’ please provide further information:

	
Have you been barred from working with adults in regulated activity?
Please note: you must only answer this question if you are applying for a position that involves regulated activity with adults.	Yes    No  

If ‘YES’ please provide further information:

	
Section C: for applications to positions which are eligible for a basic disclosure

You are applying for a security-sensitive role. We will conduct a basic disclosure on the successful applicant through the Disclosure Scotland.  You must now disclose any convictions you have that are unspent under the Rehabilitation of Offenders Act 1974 (as amended on 10 March 2014). Please see the Ministry of Justice’s web pages for further information about when convictions are considered unspent.

If you do not disclose now something that is revealed by the basic disclosure then we may withdraw any conditional offer we have made (or dismiss you, if you have begun employment).

We will treat the information you provide to us here confidentially and it will not be used unfairly against you. Nothing you declare here will automatically prevent you from being appointed (unless required by law). We may wish to discuss it with you if you are invited to interview. Any information revealed through the check will also be discussed with you. 
Do you have any convictions that are unspent under the Rehabilitation of Offenders Act 1974 (as amended on 10 March 2014)?
	Yes    No  

If ‘YES’ please provide further information:	
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. 
There is an option to tick “prefer not to say” for sensitive questions. If you do not provide any answer for a question, then we treat you as having ticked “prefer not to say”.
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.
If you are appointed, we have to provide some of this information 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	

Nationality
Which country defines your national identity? 
	Country: 
	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 background?	White:
	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	

Disability
HESA tells us what categories we have to use when we collect disability data. Our use of these categories does not mean that the University thinks that they are the most appropriate.
Do you regard yourself as in any way disabled?		Yes
	No
	Prefer not to say	
If yes, what is the nature of your disability?	Please tick the appropriate box. If you experience more than one type of impairment, please tick the box next to all of the types that apply. If your disability does not fit any of these types, please tick other.
	Specific learning disability (such as dyslexia or dyspraxia)
	General learning disability (such as Down’s Syndrome)
	Cognitive impairment (such as autistic spectrum disorder or resulting 	from head injury)
	Long-standing illness or health condition (such as cancer, HIV, 	diabetes, chronic heart disease, or epilepsy
	Mental health condition (such as depression or schizophrenia)
	Physical impairment or mobility issues (such as difficulty using arms or 	using a wheelchair or crutches)
	Deaf or serious hearing impairment
	Blind or serious visual impairment
	Two or more impairments and/or disabling medical conditions
	A social/communication impairment such as Asperger’s    
syndrome/other autistic spectrum disorder.
	Other type of disability not listed above

Religious beliefs
What are your religious beliefs?		Buddhist
	Christian
	Hindu
	Jewish
	Muslim
	No religion
	Sikh
	Spiritual
	Any other religion or belief
	Prefer not to say	

Sexual orientation
What is your sexual orientation?		Bisexual
	Gay man
	Gay woman / lesbian
	Heterosexual
	Other
	Prefer not to say	

Gender identity
What is your gender identity?		Gender identity is the same as the gender originally assigned at birth
	Gender identity is different to the gender originally assigned at birth
	Prefer not to say	

Online applications
The University has a system which allows some jobs to be applied for online. The system isn’t yet in use for every job, so please answer this question only if you have asked for a paper application form because your cannot use our online system. This will help us to improve the system so that more people can use it in future.

Why do you need a paper application form?		I have a disability and I cannot complete any online form
	I have a disability and I can complete some online forms but I had 	specific difficulties with this one (please explain what difficulties you 	had below)
	I have no access to the internet
	I tried using the online system but had technical difficulties (please 	give details below)
	Other (specify below)
Please give any more details here: