Ref No:

Application for Employment

Horsted Centre, Maidstone Road, Chatham, Kent ME5 9UQ
Tel: 01634 830633 Fax: 01634 847294

Job Title: No:

All Personal Information given is considered strictly PRIVATE & CONFIDENTIAL.

All sections should be completed. State nil or none where applicable.

Personal Details (Please use BLOCK CAPITALS and black ink)

Miss / Mr / Mrs / Ms / Dr / Rev: Surname:

Forenames: Former Names (if applicable):

Permanent Address:

Tel No Home: Business:

Please indicate if contact at work can be made: Yes No TICK APPROPRIATE BOX

Temporary Address:

Tel No: Dates at Temporary Address: NI No:

Mobile No: DFE No: (Teaching staff only)

Nationality at Birth: Present Nationality: (If different from Birth Nationality)

Do you own/have use of a Car? Do you hold a current Driving Licence?

Do you require a Work Permit to work in the UK? Yes No Work Permit No:

How many days sickness absence have you had in the last 12 months and on how many occasions?

If you have previously been interviewed for employment with Mid-Kent College please state when, details of the
post and where it was located:

Referees
Please give names and addresses of two persons, one of whom must be your present or most recent employer
(or personal tutor in the case of a student) from whom confidential references may be obtained. References will be
requested before interviews unless you indicate otherwise below by placing a cross in the box.

Name and Address: Name and Address:

Position/Relationship: Position/Relationship:

002545-ME-P APRIL 07
Education and Training
Secondary Education*
Schools Attended From (Date) To (Date) Examinations passed Date Grade

Further/Higher Education*

State State Main subjects

Name of University or Date of Title of
whether Pass Class or (principal subject
Awarding Body Award Degree
or Honours Division first)

Period of Study: From: M M Y Y To: M M Y Y Full or Part-time

Period of Study: From: M M Y Y To: M M Y Y Full or Part-time

Period of Study: From: M M Y Y To: M M Y Y Full or Part-time

Other Professional Qualifications and Membership of Professional Institutes*

Examining Body/Name of From (Date) To (Date) Qualification/Level of Date membership/
Professional Institute membership obtained Certificate granted

Please list any other training which you feel is relevant to the post*

*Attach a continuation sheet if necessary

Employment Record
Please give all employment, teaching, industrial, commercial or other experience, including voluntary work if
applicable. Each entry should be in chronological order with an account for any gaps.

Present or Last Employer*

Name and Address Position held and brief description of duties/subjects taught
Type of Business/Establishment (where applicable)

Date Full or Salary (and scale if any) and Notice required for resignation or
commenced Part-time Other Allowances (if any) date left post and reason for leaving.

Previous Employment (Most recent first)*

Position and Salary

Name and Address Please state whether Dates of Employment
Reason(s) for leaving
Type of Business/Establishment full or part-time From To

Hobbies and Interests*

Supporting Statement and Additional Information
Use this space to state briefly your reasons for applying for this post and what you feel you have to offer the
College. Please also add any additional information which you feel is relevant to your application.

Attach a continuation sheet if necessary

Availability
(To be completed by candidates applying for sessional teaching only)*
Level(s)
Subject(s) Days available Evenings available
(if applicable)

*Attach a continuation sheet if necessary

REHABILITATION OF OFFENDERS ACT 1974
In accordance with the provisions of the Rehabilitation of Offenders Act 1974 (Amendment order 1986) Mid-Kent College has a duty to ensure
that a Criminal Records Bureau check for possible criminal convictions is undertaken for all those who apply for positions that give substantial
access to children and young people up to an age of 18 years. In this connection please indicate if you have been found guilty of any offence by
any Court (even if you were only placed on probation, absolutely or conditionally discharged, or bound over by a court of law). If so please give
details of Court, charge and sentence. All applicants will be subject to a CRB disclosure.

Answering ‘yes’ does not necessarily bar you from appointment. (Every application is considered on its own merits). Please confirm that you
would have no objection to a Police check being carried out. A refusal could prevent further consideration of your application.

I certify that to the best of my knowledge this application is a true and accurate record, and I give permission for a Police check to be carried out.

SIGNED: DATE:

PLEASE RETURN YOUR APPLICATION TO THE PERSONNEL DEPARTMENT AT THE HORSTED CENTRE
CANVASSING WILL DISQUALIFY