Digital Application Form

Personal Details

Title *

Mr Mrs Miss MS

First Name *

Last Name *

NI Number *

Have you ever been known by a different name? YES/NO. If Yes, please give previous name *

Address *

Post Code *

Number of years at this address: *

If less than 3 years, please give previous postcode here:

Email Address *

Home Tel

Mobile No *

Age Band *

16 - 18 19 - 24 25 +

Date of Birth *

Ethnicity *

Have you been legally resident in the UK for more than 3 years? *

YES NO

Do you hold a current driving licence? *

YES NO

How will you travel to and from work or to and from NSEG? *

Emergency contact name and contact number: *

Relationship to you: *

Personal Statement *

Please describe briefly any personal attributes or achievements which you feel may support your application

Employment History

	Employer's Name	Job title	Date from	Date To
1

Add Row

Qualifications

	Qualification/Subject	Grade	Where & when obtained
1

Add Row

Interests and Hobbies *

Further Information

Programmes for the unemployed

Please tick which DWP unemployment benefits applies to you. Please note, this section only needs to be completed if you are applying for an unemployed programme.

Job Seekers Allowance (JSA), including National Insurance Credits
Employment and Support Allowance (ESA)
Universal Credit and my income from employment (disregarding benefits) is nil or less than £345 a month (as a sole adult claimant in my benefit claim) or £552 a month (as a joint benefit claimant with my partner)
Not Applicable

Conviction Declaration *

Have you ever been convicted of a criminal offence or do you have any pending convictions?

NO YES

If yes, please give details of conviction and of your parole officer if applicable

Are you taking any medication or under any medical supervision that we need to be aware of? *

YES NO

If yes, please give details.

Do you require any additional support? *

YES NO

If yes, please give details.

Do you have a Statement of Special Educational Needs or an Education, Health and Care Plan? *

YES NO

If yes, please give details.

Will anything indicated above affect your apprenticeship or training? *

YES NO

If yes, please give details.

Have you already taken part in any of the following?

For the Ace Academy applicants, please give details of your Jobcentre and your work coach

Declaration

Declaration *

I declare that the information given in this application is true and to the best of my knowledge.

I understand that any subsequent offer of employment / training programme is subject to satisfactory references being obtained (where required).

I understand that any false statement, misrepresentation or omission of factual information renders me liable to dismissal

Data Protection *

We may, under our recruitment and selection policies and procedures, process and distribute the data covered by this application form. Please indicate your acceptance by ticking the appropriate box. Retention – we will retain your application form on file for a period of no longer than 12 months for consideration of future vacancies.

YES – indicating ‘Yes’ means that you are providing your explicit consent within the meaning of the current data protection legislation, to the distribution of the data you have supplied within this application form to other companies for purpose of evaluation under the auspices of the company’s recruitment and selection policies and procedures.
NO – indicating ‘No’ means that the data you have supplied will only be used within NSEGTA/Ace Academy, for the purpose of evaluation under the auspices of the company’s recruitment and selection policies and procedures.

Photographs/ Images *

From time to time, we may wish to use photographs/images taken for social media, case studies, promotion of opportunities and in marketing material. Please tick the box to give us your consent to use any photos/images that feature you.

How your personal data is used:

This privacy notice is issued by the Education and Skills funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE). It is to inform learners how their personal information will be used by the DfE, the ESFA (As executive agency of the DfE) and any successor bodies to these organisations.

For the purposes of relevant data protection legislation, the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes.

Your information may be used for education, training, employment and well-being related purposes, including for research. The DfE (or agents acting on their behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training.

Your information may also be shared with other third parties for the above purposes, but only where the law allows it and the sharing is in compliance with data protection legislation.

Further information about use of and access to your personal data, details of organisations with whom we regularly share data, information about how long we retain your data and how to change your consent to being contacted, please visit: https://www.gov.uk/government/publications/esfa-privacy-notice.

Costs (Excluding Apprenticeships) *

There are no costs incurred with NSEGTA/Ace Academy finding you apprenticeship / job opportunities. However, there is 1 programme that incurs costs.

Ace Academy – If you are attending a training programme at the Ace Academy, there will be a cost incurred for the PPE (Personal Protective Equipment) that will be required for this. You will be issued with safety boots and overalls which will be yours to keep as you progress into work. The cost for this is £33. In most cases, your job centre coach will be able to assist you with making this payment by completing form 1PF1JP. It is important that your work coach is kept informed of your start date with the Ace Academy.

If you are starting in the Ace Academy, please give the following:

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