APPLICATION FORM

Southbank Centre is striving to promote equality and diversity.

Please confirm that you have read the guidance notes on page 6, job description and
person specification:
If you would like a version of this form in an alternative format, such as large print or if you require
other adjustments to the recruitment process, such as a BSL interpreter please contact
Recruitment on 020 7921 0641 or email [email protected]
You can return your form to us using the following methods:
Email [email protected]
Post Recruitment, Southbank Centre, Belvedere Road, London, SE1 8XX
Position applied for:      
SECTION A: PERSONAL DETAILS
Family name:       First name:      
Address:      

Postcode:      
Telephone: Mobile:       Home:      
Email:      

How did you hear about this      

vacancy?

REFEREES
Please give details of two people, who have known you in a professional capacity and can provide
us with an employment reference. Please refer to the Guidance Notes for further information
regarding referees.
Name:      
Address:      

Telephone number:       Email:      

In what capacity do you know this person?      
Can we contact this person prior to interview? Yes: No:

Name:      
Address:      

Telephone number:       Email:      

In what capacity do you know this person?      

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Can we contact this person prior to interview? Yes: No:
SECTION B: EMPLOYMENT HISTORY
Please list all previous employment – paid or unpaid, beginning with your most recent employment.
You can attach a CV if it fully covers the information required.

Name of organisation:      

Job title:      
Key responsibilities:      

Dates of employment: From       To      

Salary/benefits:      
Reason for leaving:      

Name of organisation:      

Job title:      
Key responsibilities:      

Dates of employment: From       To      

Salary/benefits:      
Reason for leaving:      

Name of organisation:      

Job title:      
Key responsibilities:      

Dates of employment: From       To      

Salary/benefits:      
Reason for leaving:      

Name of organisation:      

Job title:      
Key responsibilities:      

Dates of employment: From       To      

Salary/benefits:      
Reason for leaving:      

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 Continue on a separate sheet if necessary.
SECTION C: EDUCATION AND TRAINING
Please give details of qualifications obtained or being undertaken and any relevant work-related
training.

Professional qualifications/work Subjects covered Date

related training completed
                 

                 

                 

                 

                 

                 

University/school/college Qualifications and grades obtained Date obtained

                 

                 

                 

                 

                 

                 

Continue on a separate sheet if necessary.

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SECTION D: FURTHER INFORMATION
Please tell us why you would be suitable for this position and how you meet the criteria stated in
the person specification and any further information that would support your application. We would
encourage you to use examples to demonstrate this.
     

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CRIMINAL OFFENCES
Have you ever been convicted of a criminal offence? Yes: No:
If yes, please give details.
Date of conviction Offence
           
           
NOTE: If for the purposes of the Rehabilitation of Offenders Act 1974 you are a rehabilitated
person and your conviction is to be treated as ‘spent’ you do not have to include details of that
conviction unless the position for which you are applying involves you having access to persons
who are disabled or under the age of 18 or over 65.
Disclosure of a conviction will not necessarily prevent you from being considered for appointment
to a position. Also see Guidance Notes.

DECLARATION
Please confirm that you have read the guidance notes on page 6, job description and
person specification:

Are you eligible to work in the UK? Yes: No:

If you are working on a visa or work permit please give further details:
     

Please advise us of any other jobs or additional hours that you currently work elsewhere or
intend to work elsewhere, in accordance with section 7 of the Guidance Notes.
     

With reference to section 8 of the Guidance Notes, please tick if you are currently over our
Normal Retirement Age. This will not prevent you from being offered a position.

I declare that the information contained in this application is complete and correct. I understand
that if I have knowingly provided false information or withheld relevant details, it will disqualify me
from further participation in the application process or from an appointment, or if discovered after
employment, may lead to dismissal. Tick here to confirm:
If you send this form electronically and are invited for interview you will be asked to sign below
when you attend the interview. If you print off this form and send by post then please sign below.
I consent to the processing by Southbank Centre of my personal data contained within this form for
all those purposes normally associated with an application for employment and those other
reasons identified in the Guidance Notes. I acknowledge that ‘processing’ for these purposes shall
have the same meaning as in the Data Protection Act 1998.

Signature:___________________________________ Date:      

DIVERSITY MONITORING FORM

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The purpose of this form is to enable us to monitor the effectiveness of our Equality and Diversity
policies. We recognise the benefits of a diverse workforce and are striving to promote equality and
diversity. We are committed to developing positive policies to promote diversity and equality in
recruitment and employment, which ensure equal access and treatment of all applicants and
employees regardless of sex, marital status, race, colour, disability, nationality, ethnic origin,
sexual orientation, age or religious belief.
The information given in this part of the form will not be used during the selection process. This
section of the application will be detached from your application and treated confidentially.
Information given will be used to monitor and develop the effectiveness of our equality practices,
therefore we would greatly appreciate your co-operation in completing this form.
However if you would prefer not to declare this information please tick the following box:

Position applied for:      

Date of birth:      
Gender: Male: Female:

Do you consider yourself to have a disability as defined by the Disability Discrimination Act
(1996)? Yes: No:
If so, please give details:      

The following categories were used for the 2001 census by the Office of Population Censuses and
Surveys and are recommended by the Commission for Racial Equality. They do not refer to place
of birth, citizenship or nationality, but to the ethnic group to which you belong. Please tick the
appropriate box.

Asian or Asian British: Bangladeshi: Indian:

Pakistani: Other Asian background:
If ‘Other’, please specify:      
Black or Black British: African: Caribbean:
Other black background:
If ‘Other’, please specify:      
Chinese or Other Ethnic Chinese: Other ethnic group:
Group: If ‘Other’, please specify:      
Mixed: White and Asian: White and Black African:
White and Black Caribbean: Other mixed background:
If ‘Other’, please specify:      
White: British: Irish:
Other white background:
If ‘Other’, please specify:      

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GUIDANCE NOTES

Completing the application form

1. Please complete the form clearly and in black ink for photocopying purposes.
2. Please ensure any additional pages are clearly marked with your name.
3. To be considered for the position you will need to return your form to us before the closing
date. Applications received after the closing date may not be considered.
4. We would advise you to do a rough draft of your application first and then to proof read the
final version, checking it for any errors, before you return it to us.
5. We would also advise you to retain a copy for your own records.
6. Before completing the application form you should carefully read the job description and
person specification. This will include information about the main responsibilities of the job
and essential skills, qualifications, knowledge and experience required from applicants to do
this job. When you are completing the application form you will need to demonstrate how
you meet these criteria, giving clear examples. It is important to remember that when
shortlisting we will not be able to make assumptions about your experience or skills.
7. In order to comply with Working Time Regulations Southbank Centre asks everyone to
declare all additional hours that you are working or intend to work while in employment with
us. If you have another job or intend to undertake any additional hours please clearly state
this on page 1.
8. As Southbank Centre’s normal retirement age is 65 we also ask that if you are 65 or over
you declare this to us. This will not prevent you from being offered a position but will help us
to ensure that we follow the correct procedure for people working beyond our normal age of
retirement. Please declare this on page 1 as indicated.
9. Your first reference should ideally be your current or most recent employer. Your second
referee should be a previous line manager or a supervisor or a member of academic staff or
other person known to you in a professional capacity, suitably qualified to give information
on your ability to fulfil this role.

The recruitment process

• We generally try to respond to candidates applications within three weeks.
• All offers of employment are made subject to the receipt of references that meet Southbank
Centre standards and health questionnaire clearance.
• Under the Asylum and Immigration Act, we are required to ensure that anyone taking up
employment at Southbank Centre has the legal right to work in the UK. Therefore all offers
of employment are subject to the successful applicant being able to provide original
evidence to support their entitlement to work in the UK prior to taking up employment.

Rehabilitation of Offenders Act 1974 (‘the Act’)

• Unless a conviction is for the purpose of the Act ‘spent’ it must be disclosed in your
application. Where a conviction is ‘spent’ you cannot be required to provide details of a
conviction unless the position for which you are applying involves your having access to
persons who are disabled or under the age of 18 or over 65 (‘vulnerable persons’). Where
the position does involve your having access to vulnerable persons, then you must provide
details of your conviction even if it is a spent conviction for the purposes of the Act.
• Any person who is applying to be appointed to a position involving access to vulnerable
persons will be the subject of Police checks to ascertain whether they have a criminal record
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 in the event that their application is successful.
• Should you be appointed to a position in circumstances where it is subsequently discovered
that you have failed to disclose a conviction that should have been disclosed in your
application, you may be subject to summary dismissal and may also be guilty of a criminal
offence.

Data Protection
• The information contained in your application form will be used for all those purposes
normally associated with an application for employment and the interview process. Your
application form and information supplied in it will be stored securely with access restricted
to those involved in the recruitment process. Application forms from unsuccessful
candidates will be stored for 1 year and may be used for the purposes of subsequent
recruitment where your skills appear appropriate to a vacant position. If you are a successful
applicant your details will be retained on your personnel file for the duration of your
employment with Southbank Centre and for such longer period as may be appropriate.