COMMUNITY AMBASSADOR: Application Form
Candidates are requested to complete applications in black ink for copying purposes. If handwritten please
write clearly, or in block letters.
CRM Students is committed to an equal opportunities policy in employment practice. The aim of the policy is to
ensure that no employee or job applicant is subject to direct or indirect discriminatory treatment on the grounds of
sex, gender (including homosexual and lesbian orientations), colour, ethnic or national origin, age, socio-economic
background, disability, religious or political beliefs or family circumstances.
FIRST NAME:
SURNAME:
POSTAL ADDRESS (including Postcode)
CONTACT NUMBER:
CONTACT E-MAIL ADDRESS:
EDUCATION (Secondary, Further & Higher Education, including course of study)
From
To
School/College/University
Award/
Degree
(abbrev)
1
Qualification/Subject
Class/
Grade
Year of
Award
OTHER RELEVANT COURSES / TRAINING / QUALIFICATION (Eg. First Aid, Counselling etc.)
Institution / Trainer
Subject
Year of
Award
EMPLOYMENT HISTORY (most recent first)
From
To
Employer
Post Held
Tell us a bit about what interests you and why?
2
WORK AND OTHER RELEVANT EXPERIENCE
Do you have any other work experience that you think will support your application?
continue on a separate sheet if required
PERSONAL STATEMENT
Please give your reasons for why you think you would be right for the role of Community Ambassador? Try to
give us as much information as you can- including any specialist knowledge, experience and most importantly
the personal qualities you feel you can bring to this role.
continue on a separate sheet if required
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DISABILITY
Applications are welcomed from disabled people. Appropriate arrangements can be made for an interview if
necessary.
Please give details of any requirements.
REHABILITATION OF OFFENDERS ACT 1974
Prospective employers may enquire about convictions for criminal offences subject to provisions in the above Act
about 'spent' convictions and excepted classes.
ASYLUM AND IMMIGRATION ACT 1996
Where a prospective employee does not have the right to work in the UK without Home Office permission, any
offer of employment will be subject to an application for a work permit being made to and approved by the
Employment Service. In order to comply with the Asylum and Immigration Act 1996, you are asked to bring to your
interview an official document which states your NI number. This can include a P45, a pay slip, a P60 or a National
Insurance Card. Alternatively, your passport or other document which shows that you are entitled to work in the
UK is acceptable.
FALSIFICATION OF INFORMATION
Providing any misleading or false information to support your application will disqualify you from appointment or,
if appointed, will render you liable to dismissal without notice.
DATA PROTECTION ACT 1998
The information you provide will be used only in connection with your application for the post. The information
will be treated with sensitivity and in confidence at all times. It will be seen only by those involved in the
appointment process. In the case of unsuccessful applications the form will be destroyed six months after the
recruitment process ends. If you wish to see the information that is held about you, please contact the Group
Human Resources Manager.
PREVENTION OF AGE DISCRIMINATION
From 1 October 2006, the government will introduce age discrimination legislation - the final version of the
regulations was published on 9 March 2006. The October date is in advance of the December deadline set by the
Equal Treatment Framework Directive (2000/78/EC) which requires the UK to implement national legislation
preventing age discrimination. As such, CRM will not use age as a basis for decisions during the recruitment
process.
ON COMPLETION, PLEASE RETURN THIS FORM TO:
CRM Limited
5 Wallbrook Court
Hanborough House
North Hinsksey Lane
Botley OX2 0QS
I confirm that I have read and understood the statement on Data Protection above.
Signature
........................................................................
Date
.........................................................................
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CONFIDENTIAL
Equal Opportunities Monitoring Form
1. PERSONAL DETAILS
FULL NAME
POST REFERENCE
SITE
JOB TITLE
POST IS:
Full time
GENDER
Male
Part time
Female
2. ETHNIC ORIGIN
Please tick the box that you feel most accurately describes your ethnic origin.
WHITE
English
A1
ASIAN, including
Asian English, Asian Scottish, Asian Welsh, Asian British
Scottish
A2
Indian
C1
Welsh
A3
Pakistani
C2
Other British
A4
Bangladeshi
C3
Any other Asian background
C4
(Please specify)
Irish
A5
(Please specify)
Any other White background
A6
BLACK, including
Black English, Black Scottish, Black Welsh, Black
British
Caribbean
D1
White and Black Caribbean
B1
African
D2
White and Black African
B2
Any other Black background
D3
White and Asian
B3
(Please specify)
White and Chinese
B4
Any other Mixed background
B5
(Please specify)
CHINESE, including
Chinese English, Chinese Scottish, Chinese Welsh,
Chinese British
Chinese
E1
OTHER ETHNIC GROUP
Any other Chinese background
(Please specify)
MIXED
Any other Ethnic group not above
F1
(Please specify)
(Please specify)
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E2
3. DISABILITY
Corporate Residential Management Ltd is committed to providing a work environment which is open to all and to
respond, as appropriate, to the needs of people with disabilities.
Any adaptations or modifications required as a result of disability will be considered after the formal interview process.
Do you consider that you have a disability?
YES / NO
If yes, please indicate the nature of your disability by ticking the appropriate box below.
I am not aware of any additional support requirements
0
I have dyslexia
1
I am blind/partially sighted
2
I am deaf/hard of hearing
3
I am a wheelchair user/have mobility difficulties
I need personal care support
4
5
I have mental health difficulties
I have an unseen disability e.g. diabetes, epilepsy, asthma
6
7
I have two or more of the above disabilities
8
I have a disability not listed above (please specify) .......................................
9
4. NATIONALITY
My Nationality is:
I confirm I have read the notes overleaf and understood the statement on data protection.
Signed…………………………..……………………………..
Date ……………………… …………………
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