!!! Castle Vale TRA Job Application form. Please complete in black ink, as this form will be copied ...

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1. Post applied for: Castle Vale TRA Job Application form Please complete in black ink, as this form will be copied 2. Personal details: Title (Mr, Mrs, Ms etc).first name(s).. Surname/family name.. Previous surname, if changed Home address... Post code... Telephone No... (Daytime).. (Evening) Mobile No Email.. Do you need a work permit to work in the UK? Yes/No expiry.. Have you ever worked or been a volunteer/trainee at Castle Vale TRA? Yes/No If yes, please give details of dates and areas of work. How did you learn of this vacancy? If yes please give date of Page 1 of 10

If you are selected for interview which is the best way to contact you during work hours? Please give details. 3. Current/most recent employer: Company/organisation name. Address.. Postcode Telephone No. Position held. Date started employment Salary.. Date left/leaving Reason for leaving.. Outline of responsibilities/duties... 4. Previous employment, paid and unpaid (Please enter most recent first) From Dates Post held To Employer Reason for leaving Page 2 of 10

5. Education and qualifications Please include vocational and academic courses and any relevant professional membership School/college/university/ professional qualification Dates From To Subject/qualification/ professional membership 6. Training and short courses attended Please put the most recent first and include any skills based courses, e.g. use of PC s etc Dates Subject From To Certificates/qualifications Page 3 of 10

Page 4 of 10

7. Relevant skills, knowledge and experience to support your application Please give details of your relevant skills and experience and reasons for applying for this post. We will use the information you give us to make our shortlist. You should look at the job description and person specification and show how you meet the criteria we are looking for. You may find it helpful to use the headings in the person specification and job description to do this. Please continue on a separate sheet if necessary. Page 5 of 10

8. Key interests and voluntary work Please give details of any interests or voluntary work that support your application and show your skills, knowledge and experience for the job you are applying for. 9. Miscellaneous information Castle Vale keeps a record of interests of staff of any clash between someone s work at the TRA and involvements outside. If you are offered a post you are expected to declare such interests. Are you related to a current or former employee or Director (Committee Member) of Castle Vale TRA? Yes/No If yes please give details 10.Declaration under the Rehabilitation of Offenders Act 1974 Do you have any convictions, cautions reprimands or final warnings that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). Yes No The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are protected and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service Website. (Declaration subject to the Rehabilitation of Offenders Act 1974) If yes, give details Page 6 of 10

11.References Please give the names of two referees; if possible one should be from your current or most recent employer. If you are not currently working please give the name of your last two employers. If you are currently studying and not in full time employment, you should also give the name of your college principal or tutor. We will not request references without your prior consent and do not normally contact referees unless we make a job offer. Referee 1 Referee 2 Name. Position. Address.. Post code Tel no. Fax no Relationship to applicant Name Position Address... Post code. Tel no Fax no... Relationship to applicant 12.Declaration The information provided in this application will be processed (as defined under the Data Protection Act 1998) for HR Purposes and I consent to the processing. I declare that the information given on this form is true and accurate to the best of my knowledge Signature Date. Page 7 of 10

Please return this form marked Job Application to: - Castle Vale TRA Spitfire House, 10 High Street, Castle Vale, Birmingham B35 7PR Castle Vale TRA Equal Opportuni5es Monitoring Form Castle Vale TRA is striving towards the provision of equal opportunities in all areas of work. To help us monitor the effectiveness of our policy, please complete this form. The information is confidential and will be separated from your application before it goes to the short-listing panel. Your application will still be considered if you do not complete this form. Posi5on applied for: How did you hear about this posi5on? Gender Monitoring: What is your sex? Female Male What is your faith? Buddhist Rastafarian Chris9an Sikh Hindu Other please state... Jewish No Religion Muslim Prefer not to say Sexual orienta5on: Bi- sexual Heterosexual Prefer not to say Gay or Lesbian Other Age: 16 19 20 24 25 34 35 44 45 64 65-74 75 + Page 8 of 10

Disability monitoring Do you consider yourself to have a disability or a long- term health condi9on? Yes No What is the effect or impact of your disability or health condi9on? Prefer not to say Page 9 of 10

Monitoring ethnicity: How would you describe yourself? Choose one sec9on from A to E, and then 9ck the appropriate box A White White or Bri9sh White English/Sco]sh/Welsh/Northern Irish/Bri9sh Irish Gypsy/Romany/Irish Traveller Polish B Other White Other White European (include Mixed European) Black Black or Black Bri9sh Black African Black Bri9sh Black Caribbean Somali Zimbabwean Other Black C Asian Asian or Asian Bri9sh Bangladeshi or Bri9sh Bangladesh Chinese Kashmiri Vietnamese Afghani Bri9sh Asian Indian or Bri9sh Indian Pakistani or Bri9sh Pakistani Other Asian D Black or Black Bri5sh African Caribbean Any Other Black background, please write in box E Chinese or other ethnic group Chinese Any other, please write in box F Prefer not to say Thank you for comple5ng this form Page 10 of 10