Information for Applicants
Please read all information before completing your application.
Please use this application form to apply for entry onto the Disability Support Assistant
Register only.
The Open University regrets that it is unable to accept applications for Residential Schools from
applicants who are not resident in the UK or ROI.
When completing the application form please ensure you have read the associated Role
Description which includes the person specification.
Successful entry to the ‘Register’ may require attendance at a pre-school induction programme to
be held on Saturday 13 and Sunday 14 April 2013 in Milton Keynes. Successful applicants will
also be required to access the online training and reference site prior to any appointment that may
be offered to them.
Eligibility to work in the UK
All new candidates and those who have not undertaken an appointment with The Open
University in the past three years, who are invited for interview, will be required to provide
proof of their eligibility to work in the UK or Republic of Ireland by producing verifiable
documents. Details of the required documents will be sent to all candidates who are invited for
interview and the relevant original documents must be provided for checking and copying.
Please note we are unable to accept photocopies of documents; original document must be
provided for checking by Open University staff.
To find out which visas and permissions you may require in order to work in the UK, please
see http://www.ukba.homeoffice.gov.uk/ or telephone 0114 207 4074. The general enquiries
line is open from 09.00 to 17.00, Monday to Friday, excluding public holidays.
If you have not worked for the University previously, you will be required to provide proof that you
are eligible to work in accordance with Section Eight of the Asylum and Immigration Act 1996. Our
appointment offer will be withdrawn if you fail to provide such evidence.
Work permits
Because of the short period between appointment and residential school, it’s not usually possible
to get a work permit for Open University residential schools.
Disclosure and Barring Service
The work of the Disability Support Assistant (Register) brings the jobholder into contact with children
and vulnerable adults at residential schools. Accordingly, successful applicants will be asked to apply
for an Enhanced Disclosure and Barring Service check (formerly known as Criminal Records Bureau).
The DBS provides access to criminal record and other relevant information to organisations in
England and Wales. The results of the checks carried out by DBS help us make more informed
decisions when recruiting people to work with children and vulnerable adults, ensuring greater
protection for the vulnerable and affording greater protection to our students, staff and volunteers.
Entry to the ‘Register’ is subject to a satisfactory disclosure being received from the Disclosure
and Barring Service.
Disability Resources Team – Disability Support Assistant (Register) application
Issued Dec 2012
Criminal Conviction Disclosure
In line with the Rehabilitation of Offenders Act 1974, you are required to declare any unspent criminal
convictions when completing employment application forms for the Open University. For certain roles,
you will also need to declare spent convictions, pending charges/current police investigations, bind
overs, warnings and cautions or reprimands. All information you provide is treated as confidential and
will be considered only in relation to the job for which you are applying.
In instances where a conviction is disclosed, The Open University will consider whether the offence
would make you unsuitable for the type of work you are applying for.
Equality and Diversity
The Open University Equality Scheme is our single equality scheme setting out our work to prevent
unlawful discrimination and promote equality and good relations with regards to the characteristics of
age; caring and dependency responsibilities; disability; gender; gender identity; marriage and civil
partnership status; political opinion; pregnancy, adoption, maternity and paternity; race; religion or
belief; and sexual orientation.
Our vision is to create an inclusive university community and a society where people are treated with
dignity and respect, where inequalities are challenged, and where we anticipate and respond positively
to different needs and circumstances so that everyone can achieve their potential. The University
values the commitment and involvement from all our staff, students, partners and providers in working
towards the achievement of this vision.
Further information about equality and diversity is available on the University’s Equality and Diversity
website (http://www.open.ac.uk/equality-diversity/), and on the intranet (accessible to all staff).
Information for disabled applicants
If you require a copy of the application form in large print or on computer disc please Contact
us. If you have a hearing impairment, you can make enquiries on ++44 (0)1908 654901 (Milton
Keynes minicom answer phone).
Disclosure of equality information
The University monitors the participation and progress of staff in relation to a number of individual
characteristics and this information is collected in the recruitment process through an equal
opportunities monitoring form. This information is only used to assess the effectiveness of our equality
policies and is never disclosed to individuals who do not need to know it. Although the disclosure of
this information is entirely voluntary, the University encourages you to provide this information in full
when you apply for a position.
Closing date information
The closing date for applications is Thursday 28 February 2013. Applications will not be
accepted after this date.
You can return your application by:
Email: Karen.Hazel@open.ac.uk (printed signature acceptable)
Post: Karen Hazel, The Disability Resources Team, The Open University, Hammerwood Gate,
Kents Hill, Milton Keynes, MK7 6BY
Fax: +44 (0) 1908 655547
If you require assistance in completing your application or have any queries relating to the
residential schools, please contact The Disability Resources Team on +44 (0) 1908 653745 or by
email: disabled-student-resources@open.ac.uk
Application for Employment –
Disability Support Assistant (Register)
Please complete all sections of the application form as the information provided on this form will be
used as part of the selection process. If you wish to apply for more than one vacancy, a separate
application form must be completed for each vacancy.
PERSONAL DETAILS
Internal Use only
Title:
Staff Reference Number:
Surname / Family Name:
First Name(s):
Job Title:
Disability Support Assistant (Register)
Address:
For internal applications:
Staff number:
Internal telephone extension:
Postcode:
Contact numbers:
Nationality:
Day:
Evening:
Are you eligible to work in the UK?
Mobile:
Yes
Email:
Please see ‘Information for Applicants’ where you can obtain
information about the documentation required.
Are you able to work at short notice?
Maximum no. of weeks available during July – Aug:
No
SECONDARY AND HIGHER EDUCATION
Please start with your most recent education, continuing on a separate sheet if necessary.
Dates
From
To
School, College or
University
Examinations taken, results/grades obtained, Scholarships or
other distinctions.
Please state the title of any thesis if applicable.
OTHER TECHNICAL, PROFESSIONAL OR OCCUPATIONAL TRAINING/COURSES ATTENDED
(i.e. those not covered in the previous section). Please start with your most recent training.
Dates
From
To
Institute or Employer
Type of Training
e.g. Full time, Part time,
Distance Learning
Subjects Studied and Qualifications
Gained
MEMBERSHIP OF PROFESSIONAL INSTITUTES OR SOCIETIES (if appropriate)
EMPLOYMENT HISTORY
Please provide details of all previous employment, starting with your most recent employer.
Dates
From
To
Employer's Name, Address and
brief description of the type of
Industry
Position(s) held and brief
details of duties
Current/final
salary and reason
for leaving
AVAILABILITY
Please specify your availability for the following weeks during the 2013 residential school period (you can
apply for multiple weeks):
Sat 29 June
Sat 06 July
Sat 13 July
Sat 20 July
Sat 27 July
Sat 03 Aug
Sat 10 Aug
Sat 17 Aug
SPECIFIC INFORMATION
Please specify the location you are able to support at along with the level of experience you hold for
each chosen module type (you are able to choose multiple sites). An information sheet which
describes, in detail, the residential elements of the module can be found on our website
www.open.ac.uk/disability/residential-school-module-info.php
High
University of Bath
DD303 (Cognitive Psychology)
DXR222 (Exploring Psychology Project)
TXR120 (Engineering: an active introduction)
TXR220 (Engineering in action)
Queen Mary’s, London
AXR272 (Art History Residential School)
University of Nottingham
DD303 (Cognitive Psychology)
MSXR209 (Mathematical Modelling)
University of Sussex
OpenPlus SXR103 (Practising Science)
DXR222 (Exploring Psychology Project)
DD303 (Cognitive Psychology)
Friedrich Schiller University, Jena
L203 (Motive: Upper Intermediate German)
University of Santiago de Compostela
L204 (Viento en popa: Upper Intermediate Spanish)
University of Caen, Normandy
L211 (Envol: Upper Intermediate French)
Observatori Astronomic de Mallorca
SXP288 (Practical science: physics and astronomy)
Preston Montford Field Centre
SXE288 (Practical environmental science)
Malham Tarn Field Centre
SXE288 (Practical environmental science)
Medium Low
Do not
wish to support
DISABILITY RELATED EXPERIENCE
Please rate your experience level against each disability category:
High
Minimal
None
Do not
wish to support
Aspergers Syndrome
Autism
Anxiety
Hearing Impairment
Depression
Dexterity
Dyslexia
Epilepsy
Mental Health
Mobility
Visual Impairment
OTHER RELATED EXPERIENCE
Please tell us whether you have experience and are willing to provide support in the following areas:
Yes
No
Yes
Fluent in French
Fluent in German
Fluent in Spanish
Typed note taking
Written note taking
Wheelchair assistance
No
Please provide your height and weight…………………. (This information is required in the event of suitably
matching you to the requirements of a student requesting mobility assistance).
Are you willing to support a student attending a field trip or site visit?
Yes
No
Are you willing to support a student within a laboratory environment?
Yes
No
Do you have a current first aid certificate?
Yes
No
If answering ‘yes’, would you be prepared to act as a First Aider if appointed? Yes
No
Please give details of your most recent training/refresher session:
SHARING CONTACT INFORMATION WITH STUDENTS
When Disability Support Assistant (Register) appointments are made, we ask the student to make contact
with you prior to the school start date so that you can both discuss your expectations of one another.
Please confirm which contact method(s) you are happy for us to share with the student:
Yes
Telephone (day)
Telephone (eve)
Mobile number
No
Email
ADDITIONAL SUPPORT REQUIREMENTS
Please let us know if you have a disability or are likely to have additional support needs at residential
school. This information is given for the purposes of providing appropriate facilities and is not considered
in appointment decisions. If you need further information on the facilities at our school venues, please
contact the Disability Resources Team.
Do you have a disability or additional support requirement?
Yes
No
Please select the option(s) that best describe your disability/additional support needs
Dietary
Hearing
Mobility
Manual Skills
Speech
Dyslexia
Mental Health
Personal Care
Fatigue/Pain
Sight
Other
ADDITIONAL INFORMATION
Describe briefly the nature of your present appointment, or any other position which you have held that
you consider relevant to this application. Please provide details and evidence of how you meet the
person specification as set out in the accompanying Role Description document. Please continue on a
separate sheet if necessary.
Any information which you think is relevant but is not covered elsewhere please write on a separate
sheet and attach to the application form.
Have you attached any continuation sheets to this application?
Yes
No
REFERENCES
Within the application you are asked to show how you meet the role requirements and person
specification. Please give below a minimum of two names and addresses of people (including your
current or most recent employer) who we may contact to provide evidence of this. Please note you do
not need to name any referees if you are a full-time member of University staff, a current Associate
Lecturer, or have held a Disability Support role within the past three years.
Please note that it is your responsibility to ensure that any application for an appointment at
residential schools does not affect your Terms and Conditions of Service if you are already in full-time
employment.
1
Most recent/current Employer
2
3
Relationship:
Relationship:
Name:
Name:
Name:
Address:
Address:
Address:
Post code:
Post code:
Post code:
Phone number:
Phone number:
Phone number:
Mobile:
Mobile:
Mobile:
Email:
Email:
Email:
If you are offered a position, please note it is University policy to obtain the most current
employer reference before the written offer of employment can be sent out.
If any referee knows you by a different surname please give details:
Note for internal applicants:
One referee must be the current Head of Unit (or his/her nominee).
DISCLOSURE OF CRIMINAL CONVICTIONS
To apply for a job at the Open University you must tell us about any unspent criminal convictions you
have.
When applying for certain jobs, you will also need to declare spent criminal convictions, pending
charges/current police investigations, bind overs, warnings and cautions or reprimands. (See item 2
below).
The information you provide will be treated as strictly confidential and will be considered only in relation
to the job for which you are applying.
If you disclose a conviction, it doesn’t necessarily mean that we will not consider and appoint you. Our
main consideration will be whether the offence would make you unsuitable for the type of work you are
applying for.
1. Please read carefully the notes in this section and enter any unspent convictions below.
2. Certain jobs are exempt from the Rehabilitation of Offenders Act 1974. This means that you must
also state ‘spent’ criminal convictions, pending charges/current police investigations, bind overs,
warnings and cautions or reprimands if you are applying for a job where there is likely to be regular
contact with under 18 year olds and other vulnerable groups. There may be other specified jobs that
are also exempt from the Act – where this is applicable it will be indicated in the job advert and/or
the accompanying recruitment information. A Disclosure and Barring Service disclosure will be
required for all these posts that fall into this category where an applicant is offered the position.
Do you have any criminal convictions to declare?
Yes
No
If yes, please complete the section below:
Offence
Date of Conviction
Sentence
Further information in relation to any conviction may be required at interview.
Details of relevant convictions and time periods are as follows:
Sentence
Becomes ‘spent’ after
Sentence of imprisonment or youth custody exceeding 6 months but not
exceeding 30 months
10 years
A sentence of imprisonment or youth custody not exceeding 6 months.
7 years
A sentence of borstal training.
7 years
A fine or other sentence, not otherwise covered in this chart, such as a
compensation or community service order or probation order received on
5 years
or after 3rd February 1995.
An absolute discharge.
6 months
A probation order, conditional charge, bind over, fit person order,
1 year or until the order expires
Supervision order or care orders under the Children and Young Persons
(whichever is the longer), or 5
years if a probation order was
made on or after 3rd February
1995.
Acts (and equivalent in Scotland).
Cashiering, discharge with ignominy or dismissal with disgrace from the
armed forces.
10 years
Simple dismissal from the armed forces.
7 years
Detention by direction of the Home Secretary
A detention period exceeding 6 months but not exceeding 30 months.
5 years
A detention period not exceeding 6 months.
3 years
A detention order.
3 years
A detention care order.
3 years
A remand home order, an approved school order or an attendance centre
order.
The period of the ‘order’ plus a
further year after the order
expires
A hospital order under the Mental Health Acts.
The period of the ‘order’ plus a
further 2 years after the order
expires, with a maximum of 5
years from the date of
conviction
Sentences exceeding 30 months
A sentence of imprisonment or youth custody more than 30 months.
Never becomes ‘spent’
Further notes:
If you were under 17 years of age on the date of your conviction, please halve the period shown in the
right-hand column. This does not apply to sentence under the heading of ‘Detention by direction of the
Home Secretary’.
For the purposes of calculation a ‘spent’ conviction, it does not matter whether a sentence was
suspended.
When you apply for specific roles you must also declare spent convictions, pending
charges/current Police investigations, bind overs, warnings/cautions or reprimands. If you are
employed, failure to declare or falsification of information will result in your dismissal without
notice.
YOUR DECLARATION
I certify that the above information (and any further information enclosed) is correct and I agree
that The Open University may take reasonable steps to verify this information (e.g. by obtaining
proof of qualifications). I agree to The Open University processing and retaining the personal
information contained on this form for any purposes connected with my application, my
employment record if appointed, and any institutional analysis.
I understand that an appointment is subject to providing suitable proof of eligibility to work in the
UK; a satisfactory Enhanced Disclosure from the Disclosure and Barring Service; relevant checks
required under the Disclosure of Criminal Convictions and attendance at the pre-school induction
programme in April 2013.
Name
Date Completed
If an applicant is invited to an interview they will be asked to sign this form to authenticate the
content.
Signature
Date
Interviewed
You have the right under the Data Protection Act to a copy of information held about you (the right
of ‘subject access’). You can obtain this information by writing to: The Data Protection Coordinator, The Open University, PO Box 497, Walton Hall, Milton Keynes MK7 6AT.
Please ensure that you return the completed application form including the attached Equal
Opportunities monitoring form (which must have your date of birth completed in order that
your application can be progressed) to the relevant Recruitment Co-ordinator at the
address specified on the further particulars for this vacancy.
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.
First Name:
Family Name or Last 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 Equality 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):