Recruitment Monitoring Questionnaire

Family for Every Childs formation is guided by a diverse Steering Committee of 15 national civil society organisations, with the international NG EveryChild !roviding !ractical su!!ort" Family for Every Child and EveryChild, who !rovide us with #$ su!!ort, are committed to e%uality of o!!ortunity in the recruitment, retention and develo!ment of our wor&force in order to ensure it reflects and attracts talented !eo!le from the diverse society within which it o!erates" 'he !ur!ose of this e%uality monitoring form is to ensure that our !olicies and !rocedures do not inadvertently discriminate on any s!ecific grou!, and are fair and trans!arent" (e would li&e to assure you that any information you !rovide in this form will be &e!t confidential and will be !rocessed in line with the re%uirements of the )ata *rotection +ct, 1,,-" .our data will therefore be only used for statistical !ur!oses" No information will be !ublished or used in any way which allows any individual to be identified" (hilst com!leting this form is not a mandatory re%uirement, your co/o!eration in !roviding us with accurate data would greatly assist us to !romote e%uality and diversity within our organisation"
Position Applied for: First Name: Surname: Date of Birth: Disability 0nder the )isability )iscrimination +ct 1,,5 1))+2 disability is defined as any !hysical or mental im!airment or long/term health condition which has a substantial and long term adverse effect on a !ersons ability to carry out normal day to day activities" Do you consider yourself to ha e a disability as defined by the DDA !""#$ .es No *refer not to say

% &ould describe myself as ha ing the follo&ing: 'ender: 3ale Female

(thnic origin: 1*lease tic&2 )hite 4ritish 6rish ther Mi*ed heritage (hite 5 4lac& Caribbean (hite 5 4lac& +frican (hite 5 +sian ther 1!lease state2 Asian 6ndian *a&istani 4angladeshi ther 1!lease state2 Blac+ or Blac+ British Caribbean +frican ther 1!lease state2 ,hinese or other Chinese ther 1!lease state2

)here did you see this post ad ertised$ ----------------------

Application Form
*lease return com!leted a!!lication form to7 *$68+'E 5 C NF6)EN'6+9 3aria 'sang, #$ +dvisor *ost7 : 4ath *lace, 9ondon EC;+ <)$ Fa=7 >;> ??;, -<<, 1F+ 3aria 'sang2 Email7 recruitment@everychild"org"u&

Position applied for: ,losing date: !st %nter ie&: .nd %nter ie&:

$esearch and +dvocacy

fficer

1;7>> 1G3'2 1-th 3arch ;>1: (ednesday ,th A 'hursday 1>th +!ril ;>1: '4C

Personal Details
/itle: First Name: Surname: Address:

(mail address: ,ontact phone number: 0oliday arrangements planned: /his position can be based in the 12 or o erseas3 Please confirm the location that you intend to &or+ from and that you ha e the rele ant &or+ isa to do so3 /he first inter ie& is due to be held on "th 4 !5th April .5!63 Are you able to attend$ )here did you hear about this acancy$

6ntended wor& location7 (or& visa7 .esBNo

(ducation 0istory School Name of School Dates attended Qualifications and grades

,ollege71ni ersity Name of ,ollege71ni ersity Dates attended Qualifications and grades

8ther training Name of ,ourse7/raining Dates attended Qualifications

(mployment 0istory 1Starting with most recent first2 Name of (mployer: 9ob /itle: Dates position held: Main responsibilities:

Reason for :ea ing:

Name of (mployer: 9ob /itle: Dates position held: Main responsibilities:

Reason for :ea ing:

Name of (mployer: 9ob /itle: Dates position held: Main responsibilities:

Reason for :ea ing:

1*lease continue on another sheet if a!!ro!riate2

Supporting %nformation
*lease tell us how you thin& your s&ills and e=!erience meet the criteria outlined in the Cob descri!tion and !erson s!ecification" .ou should !rovide enough information to fill an +: sheet"

Supplementary %nformation
#ave you a!!lied to wor& at Family for Every Child beforeD 16f yes, !lease state which Cob a!!lied for2 CurrentB9ast salary )o you have !ending or have you ever been convicted of a criminal offence 1other than minor driving offences2 which is not a s!ent conviction under the $ehabilitation of ffenders 9egislationD 6f yes, !lease give further information 1use se!arate sheet if necessary27 Family for Every Child from time to time re%uires its em!loyees to wor& overtime which is un!aid" (ould you be able to wor& overtimeD NeverB ccasionallyBFre%uently +s a matter of good !ractice for organisations that wor& with children, all staff at Family for Every Child are re%uired to consent to a bac&groundB !olice chec&" Please delete as appropriate: 6 give consent to a bac&ground chec&B6 do not give consent to a bac&ground chec&"

References
6f we offer you the !ost we will want to ta&e u! references immediately after the offer is made, but not before" +ny offer of em!loyment will be subCect to our receiving satisfactory references" *lease state the name of at least two referees below, one of who must be your !resent or immediate !ast em!loyer"

!3 Name: ,ompany: 9ob /itle: ,ontact details: Relationship to you: .3 Name: ,ompany: 9ob /itle: ,ontact details: Relationship to you:

Declaration of Applicant

6 confirm that the above information is correct" 6 understand that any false information or deliberate

omissions will dis%ualify me from em!loyment or may render me liable for dismissal

Signature: ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;

Date: ;;;;;;;;;;;;;;;;;;;;;;;;

)ata *rotection7 .our signature on this form authorises the *ersonnel +dministrator to !rocess this !ersonal data and sensitive !ersonal data for the !ur!oses of your a!!lication for em!loyment with Family for Every Child" 6t will be treated and filed as confidential information" 6t will not be made available to a third !arty without written !ermission from the a!!licant" 6f you are a!!ointed to the !ost your a!!lication form will be &e!t for the duration of your em!loyment" 6f you are not a!!ointed to the !ost, the form will be &e!t for E months and then destroyed" 6 understand that the !ersonal data which 6 have !rovided on this form may be stored in !a!er or electronic form in accordance with EveryChilds !olicy on )ata *rotection and with the !rovisions of the )ata *rotection +ct 1,,-"