VQ Assessment Centre
Application form for Assessment and Internal Quality Assurance roles
Post applied for e.g. assessor/quality assurer relating to
which vocational qualification(s) and levels
Where did you hear about this post? e.g. Open
University website
YOUR PERSONAL DETAILS
Surname
First names
Dr/Mrs/Mr/Miss/
Ms/Other
Nationality
If not British or EU, do you have authority to work
in the UK?
Yes
No
Address
Postcode
Telephone
Home
Business
E-mail address
Fax No.
ASSESSMENT AND VERIFICATION QUALIFICATIONS
Qualification
Date achieved or date due for
completion
Original certificate available for inspection
Yes/No
D32/D33
A1 / A2
D34 / V1
Level 3 Certificate in
Assessing Vocational
Achievement
OTHER RELEVANT QUALIFICATIONS
Awarding body
Qualification
Date achieved
YOUR OCCUPATIONAL AND PRACTITIONER EXPERIENCE
Please provide details of your occupational and practitioner experience and state how it relates to this particular
vocational qualification e.g. dates, job roles, responsibilities etc.
YOUR ASSESSMENT AND/OR VERIFICATION EXPERIENCE
Please provide details of your assessment and/or quality assurance (verification) experience, particularly detail your
recent experience e.g. within the last twelve months
CANDIDATE ALLOCATION INFORMATION
Please state your preferred maximum number of
learners
Please confirm your preferred activities e.g. workplace
observations, support visits, programme development,
desk assessment, internal quality assurance,
facilitating support workshops, providing guidance
through online forums
Please provide details of the geographical areas within
which you can travel (this is essential for observations
and support visits)
Please provide the telephone contact number to be
provided to learners
Please provide the email contact address to be
provided to learners
ADDITIONAL INFORMATION
Please use this space to give any information, which you think is relevant but is not covered elsewhere.
AUTHORISED SIGNATURE
Please sign the box below. This will be held on file as your authorised signature.
Please provide the date and disclosure number of your most recent Criminal Records Bureau check
I certify that the above information (and any further information enclosed) is correct. Any information
provided may be held by the University in accordance with the Data Protection Act 1998.
Signed
Date
You have the right of access to your personal records held on computer files and enquiries should be sent
to the Data Protection Co-ordinator, PO Box 497, The Open University.
EQUAL OPPORTUNITIES MONITORING FORM
CONFIDENTIAL
EQUAL OPPORTUNITIES MONITORING FORM
The Open University is an equal opportunities employer. We have an equal opportunities policy, the
aim of which is to ensure that no job applicant receives less favourable treatment on irrelevant
grounds (e.g. sex, race, colour, ethnic or national origins, age, disability, religious, sexual orientation
or marital status), nor is disadvantaged by conditions or requirements which cannot be shown to be
justified and relevant to the job. In order to ensure that this policy is carried out, it is necessary for us
to have some means of monitoring our recruitment and selection activity. Only by such measures will
we be able to identify potential sources of discrimination and take remedial action. For this reason
alone we would be most grateful if you would answer the following questions. On receipt, the
monitoring form will be separated from the application form and securely stored. It will be treated as
strictly confidential and will be used for statistical monitoring only. To carry out this approach we need
your assistance and would be grateful if you would provide the information requested; none of this
information will be seen or used during the selection process.
Section 1
This information must be provided to carry out our administration procedures; however it will not be used
during selection processes. Without your date of birth your application can not be progressed.
Family Name or Last Name:
First Name:
Date of Birth:
Section 2
Please select one of each of the following sections which best describes you:
Gender:
Male
Disability:
Do you consider yourself disabled?
Female
Yes
No
Information refused
(Under the Disability Discrimination Act, a disability is defined as a physical or mental impairment which has a substantial and long-term
adverse effect on a person's ability to carry out normal day to day activities).
Ethnic origin:
Indian
White – Scottish
Irish Traveller
Bangladeshi
White – Irish
Other White Background
Pakistani
White – British
Other Black Background
Chinese
White and Asian
Other Mixed background
White and Black
Caribbean
Black – African
Other Asian Background
White and Black African
Black – Caribbean
Any other ethnic group
I do not wish to declare
Applicant number (Office use only):