Road Safety Training & Services | Fleet … · Web view0845 270 4380 | [email protected] |...

EQUAL OPPORTUNITIES QUESTIONNAIREWe are committed to ensuring that all freelance instructors are treated equally and not discriminated against on the grounds of age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership, and pregnancy and maternity. This form helps us to adhere to equal opportunities best practice and make progress towards identifying any barriers to diversity among our workforce. Please complete this form and return it with your application. The form will be separated from your application on receipt and will play no part in the recruitment process nor will it be placed on our personnel files. You are not obliged to answer all the questions but the more information you supply, the more effective our monitoring will be. All information supplied will be treated in the strictest confidence. Thank you for your assistance.

What is your gender (please tick)?(If you are currently undergoing the process of gender reassignment, please tick your future gender)

Male ☐ Female ☐

How would you describe your ethnicity (please tick)?

A

White:

B

Mixed race:

C

Asian or Asian British:

British - English, Scottish or Welsh

☐ White and Black Caribbean

☐ Indian ☐

Irish ☐ White and Black African

☐ Pakistani ☐

Other White background

☐ White and Asian

☐ Bangladeshi ☐

Other Mixed background

☐ Other Asian background

☐

D

Black or Black British:

E

Chinese and other groups:

Caribbean

☐ Chinese ☐ Prefer not to say ☐

African

☐ Other ethnic group ☐ Other Black background

☐

Hadley Park East | Telford | Shropshire | TF1 6QJ

0845 270 4380 | [email protected] | www.thettcgroup.comRegistered Office: Hadley Park East, Telford, Shropshire, TF1 6QJ - Registered in England & Wales No.06214074

Is your age between (please tick):

16-24 ☐ 25-29 ☐ 30-39 ☐

40-49 ☐ 50-59 ☐ 60 or over ☐

How would you describe your sexual orientation (please tick)?Heterosexual ☐ Bisexual ☐ Lesbian ☐

Gay ☐ Prefer not to say

☐

How would you describe your Religion or Faith?My Religion or Faith is:

Prefer not to say ☐

I do not have a Religion or Faith ☐

How would you describe your marital status (please tick)?

Divorced ☐ Married/Civil Partner

☐ Partner ☐

Single ☐ Widowed ☐ Prefer not to say

☐

The Equality Act 2010 defines a disability 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". An effect is long-term if it has lasted, or is likely to last, more than 12 months. Do you consider that you have a disability under the Equality Act (please tick)?

Yes ☐ No ☐Used to have a disability but have now recovered ☐ Don't know ☐Prefer not to say ☐

Thank You for your assistance in helping TTC with its commitment to Equality and Diversity



FREELANCE WORK APPLICATION FORMPRIVATE AND CONFIDENTIAL

ANSWER ALL QUESTIONS HONESTLY AND TRUTHFULLY READ THE DECLARATION AND DATA PROTECTION SECTIONS SIGN AND DATE THE FORM, IF YOU ARE COMPLETING ELECTRONICALLY PLEASE INSERT A

ESIGNATURE OR SIGN AND RETURN A SCANNED COPY.PLEASE CONTACT US IF YOU NEED THE APPLICATION FORM IN AN ALTERNATIVE FORMAT

Please complete this form accurately, giving as many details as possible of your skills and experience relating to this freelance function.

Please state which Freelance position: (Balanceability Instructor / Bikeability Instructor / Safe Urban Driving Instructor) you have applied for.Freelance Position Applied for:

Where did you hear of this opportunity?

(Please give name if referred by a current instructor)

Have you worked for Balanceability or TTC Cycle Experience before? If so please give details.

Details of any other employment or business interests relevant to the role?

Details of other road safety training providers you freelance with

PERSONAL DETAILS

First name(s)

Surname

Address (including postcode)

Email address

Telephone number Mobile:

Alternative:

Nationality

National Insurance Number



DISCLOSURE & BARRING SERVICE

Because we work with vulnerable groups, including children you are required to have an enhanced current record check with the Disclosure & Barring Service (DBS) or Protecting Vulnerable Groups (PVG).

Please provide your DBS/PVG number, issue date and attach a scanned copy. We will not be able to process your Bikeability/Balanceability application without this information.

For the DBS to be portable you will need to be registered with the update service. Please confirm if your DBS is portable?

Have you completed any Safeguarding Children training? We will not be able to process your Bikeability/Balanceability application without this information.

ROAD SAFETY TRAINING RELATED INFORMATION

National Standard Instructor Number (leave blank if applying for Balanceability only role)

Instructor Training Organisation whom you originally qualified with and the dates of your original Instructor Training Course (leave blank if applying to become a Balanceability Instructor)

Please provide your First Aid qualification provider, course name and expiry date and attach a scanned copy of your First Aid certificate

Please provide name of your public liability Insurance Company and attach a scanned copy of your policy/appropriate membership card.

Have you completed 35 hours of Cycle Training Delivery?

Do you have knowledge of: CLOCS, FORS or Driver CPC?

Have you completed an approved Safe Urban Driving ‘Train the Trainer’ course? (Please provide dates and provider)

Do you hold a valid UK Driving Licence with category B entitlement and no more than 3 penalty points? (Please provide licence number; for certain schemes a check with the DVLA will have to be completed.)



INTERESTS AND OTHER RELEVANT INFORMATIONGive details of any leisure interests/hobbies you have and/or any further information which you think may be useful for us to be aware of in this freelance position.

REFERENCESPlease provide the full names and addresses of two referees (not relatives or friends), which should preferably be previous employers, whom we may contact with regard to your application. All offers of employment are strictly subject to satisfactory references being received.

Reference 1 Company Name & contact

Address

Telephone

Occupation

Capacity and period known to you

Have you any objection to these references being obtained prior to interview?



SKILLS, EXPERIENCE and QUALIFICATIONSPlease outline clearly the skills, knowledge, experience and other relevant qualifications you have gained and how it would enable you to undertake this role effectively (please continue on a separate sheet if necessary) or activities outside of work that you feel are relevant to the post (e.g. voluntary, project work, etc.).

Before applying, please confirm you have attached, are able to provide evidence or willing to undertake:

NSIP/NSIQ/NSIT number ☐ Valid First Aid Certificate ☐

Valid Enhanced DBS check ☐ Valid Safeguarding Training ☐

Drivers Licence check (SUD only) ☐

DECLARATION

I declare to the best of my knowledge and belief, the details I have given either in writing on this form or verbally are correct and that any misrepresentation, false, misleading or inaccurate information given by me will be sufficient grounds for revoking any offer of freelance work.

I understand that the Company has the right to check on any experience, achievements, qualifications and skills claimed by me on this form and I agree that such checks may be made by the Company.

DATA PROTECTION ACT 1998

I understand that the Company needs to collect and use certain types of information about freelance workers in order to operate its business and to fulfil its legal obligations under the Data Protection Act 1998 and that the information I have provided on this application form will be used as part of my personnel records.

I consent to the Company holding such information on file only for as long as it considers necessary to fulfil the purpose for which it was obtained and to process (including disposing and destroying) it in accordance with the eight Data Protection Principles and the other requirements of the Act and any other procedures laid down by the Company for this purpose from time to time.

I understand that the Company will take all reasonable precautions at all times to guard information against any unauthorised access and use.

This information will be used solely in the recruitment process and will only be retained for as long as is deemed necessary. Such information may include details relating to equal opportunities, these will be used solely for internal monitoring and will not be disclosed to any third party.

Signed __________________________________________ Dated ______________________

We are an equal opportunities employer.

You may include a C.V. with this application.



Please return this form to: HR Department, TTC Group, Hadley Park East, Telford, TF1 6QJ

Email: [email protected]

Road Safety Training & Services | Fleet … · Web view0845 270 4380 | [email protected] |...

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