Reference one. Name. Position. Company name. Address. Postcode. Telephone. . Reference two. Name. Position. Company name. Address.

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1 job application form post applied for step 1.1 about you Surname First forename Previous name (if applicable) Other initials Known as Home address Title Mr/Mrs/Miss/Ms/Dr step 1.3 references Two references requested, one of whom should be your present employer. We will only contact your present employer with your permission. Reference one Position Address Daytime contact no Evening contact no Telephone step 1.2 present employment Present post (title) Date appointed Reference two Position Address Salary Employment address Telephone

2 step 1.4 employment history Please state your full employment history starting with your current position.

3 step 1.4 employment history continued... Please continue on a separate sheet of paper if necessary.

4 step 1.5 education Please continue on a separate sheet of paper if necessary. step 1.6 professional development and other qualifications Please briefly state any relevant professional development undertaken in the last five years. Please continue on a separate sheet of paper if necessary.

5 step 1.7 professional experience Please briefly state any relevant professional experience including for example presentations, representations and publications. Please continue on a separate sheet of paper if necessary. step 1.8 further information If asked to attend an interview, are there any special arrangements we should take into account when planning the interview process? The association will endeavour to make any necessary reasonable adjustments to the job and the working environment to enable access to employment opportunities for disabled applicants or continued employment for any employee who develops a disabling condition. The job description sets out the main duties of the post at the date when it was drawn up. Such duties may vary from time to time without changing the general character of the post or the level of responsibility entailed. Such variations are a common occurrence and cannot of themselves justify a reconsideration of the grading of the post. The successful candidate may be subject to an enhanced CRB check. Signature step 2.0 Please return the completed form, with a letter of application to: Angela Stewart Operations Manager ASCL 130 Regent Road Leicester LE1 7PG T: F: E: jobs@ascl.org.uk step 1.9 applicant s statement I can produce the original documents of my qualifications and will present them if called for at interview. I confirm that the statements in this application are true and that I have not omitted anything relevant to this application. I confirm I am entitled to work in the UK. the best of my knowledge and belief there is nothing in my professional or personal life which could bring ASCL into disrepute. The following is not an exhaustive list of professional or personal issues which could in any way bring ASCL into disrepute: Bankruptcy Disqualification as a director of a limited company Criminal convictions. Date step 3.0 How did you hear about the vacancy? Local newspaper advert Online advert Referral/recommendation Internet search Please specify National newspaper advert ASCL website Leader magazine Other

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