NIAB - National Institute of Agricultural Botany

Application for employment

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Part I - This section for HR* use only

Please complete both parts of the form fully and accurately

Ref no:

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Closing date:

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Post advertised in:
Position applied for:

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Available start date:

Personal Details

Mr/Mrs/Miss/Ms/DrDay Telephone No.:
Surname:Home or work?
Other names:Mobile Telephone No.:
Address inc. Postcode Email:

Do you have the right to work in the UK?
Not Applicable Yes No

References

Please give details of two referees (other than relatives), including your present or last employer or place of education if you have no worked since leaving full-time education:

1.Name:2.Name:
Position:Position:
Address: Address:
Telephone:Telephone:

We will only contact your referees when you have accepted a conditional job offer (any job offer is subject to the receipt of satisfactory references)

Health

If you have a disability and would like us to make reasonable adjustments to assist you when attending an interview or with your application, please let us know:

Criminal offences

Have you ever been convicted of a criminal offence which is not spent as defined in the Rehabilitation of Offenders Act 1974?
Yes
No
If yes, please give details

Equal opportunities

Date of Birth:
Sex: Male
Female
Marital status Single
Married
Divorced
Widowed
Ethnic/Racial Origin: Asian or Asian British
Black or Black British
Chinese
White
Mixed
Any other ethnic group

*Information requested in Part I of this form enables us to administer and monitor recruitment according to our policy of non-discrimination. The information is restricted to HR except for information relating to criminal offences which may be disclosed to the recruiting manager if specifically relevant to this particular job.

Part II

Education, Training and Qualifications

1. Secondary Education
(if you have a degree, only show "A" levels or equivalent. Otherwise give all exam results)

Date of examSchool/College and TownLevelSubjects and Grades

2. Tertiary Education

DateUniversity or InstitutionDegree/ClassTitle of Course

3. Post Graduate/Professional Qualifications

DateUniversity or InstitutionDegree/ClassTitle of Course

4. Work experience

Include all work for the last 10 years or 5 jobs, whichever spans the longest period. Start with the most recent job. Explain career breaks.

 Employer:
Name/Address/Business		Key ResponsibilitiesKey Achievements
From:

To:

Position:

Salary (£):

Reason for
Leaving:
From:

To:

Position:

Salary (£):

Reason for
Leaving:
From:

To:

Position:

Salary (£):

Reason for
Leaving:
From:

To:

Position:

Salary (£):

Reason for
Leaving:
From:

To:

Position:

Salary (£):

Reason for
Leaving:
From:

To:

Position:

Salary (£):

Reason for
Leaving:

5. Do you have a full, clean Driving Licence?
Yes
No

6. If no, do you have access to independent means of transport? Please explain type of transport/arrangement.

7. With which IT programs/packages do you have familiarity? (indicate whether Advanced, Intermediate or Basic)

8. Any other relevant training, interests or information? For research posts only - please list published papers, including a URL to the abstract where possible

9. Referring to the job description & Person Specification, describe what you would bring to the role in terms of skills, experience, aptitudes and attitudes

Upload a supporting letter

You may optionally upload a supporting letter in addition to completing the information above. Please do not upload a CV, they will not be accepted.
(File format must be .pdf, .doc, .docx, or .rtf. Maximum file size 1.4 MB)

Signature

I certify that this application is true and complete to the best of my knowledge. I understand that false or withheld information may result in dismissal/withdrawal of any offer of employment.

I consent to NIAB TAG processing the information that I provide for the purposes of recruitment and selection and employment with the company.

(please tick the box if you agree with the above statement)

 

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