CONFIDENTIAL

274 Banbury Road, Oxford OX2 7DZ

Application Form
If you choose to send a hard copy of the form, please sign the declaration at the end. If you are completing this in handwriting please use black ink. If you choose to email the form you will be asked to sign a printed version if you attend interview. (Please note that some of the information given will be entered into Oxfams recruitment database but will not be disclosed outside Oxfam without your consent). Further information about Oxfams work can be found on our website on the Internet; http://www.oxfam.org.uk/

Application For: Reference No:

N/A

Disability/Impairment In order to improve the diversity of our workforce, Oxfam GB is committed to shortlisting candidates meeting minimum selection criteria who have a disability or impairment. For this reason please indicate if you consider yourself to have a disability or impairment.
Yes No If yes please give details . . . . . . . . ........................................... ......................

All Applicants
(Please complete in capital letters)

Surname

Initials

Address for correspondence

MOBILE NO.

Telephone (home) Telephone (work)

Facsimil e E-Mail Yes

May we contact you at work? - we will do so discreetly

No

Present and Previous Staff & Volunteers

Yes No
Are you currently employed by Oxfam? Have you left Oxfams employment in the last 12 months? Are you currently a volunteer with more than 3 months continuous service? For current staff: If this application is for a secondment please obtain your managers signature to indicate his/her agreement Managers name Manager's signature Managers telephone number

Date Oxfam GB is a member of Oxfam International. Registered Charity No. 202918

Please complete these sections carefully after reading any supplementary information regarding the post, particularly the job description and list of job competencies. The decision to invite you for interview will be based on the information you provide on this form and how closely you meet the specified competencies.

Qualifications and Training Employment History

Please give details of your education, qualifications and training relevant to the application. Dates Qualification/ Course completed Place of Education/Training From summarise your previous jobs starting with the most recent. Please To Current Notice Required: Current Salary: Dates of employment. From To Employers name, address and nature of business. (Please also indicate location of post if based outside UK). Job title and summary of main duties. Grade/Result

Reasons for leaving.

Please use this section to indicate how far you meet each of the competencies required for the post. List experience, achievements, knowledge, personal qualities and skills which you feel are relevant, against each competency. You may include paid and unpaid work, work within the home and leisure interests.

Achievements, Personal Qualities & Skills

Personal Details
Yes Do you hold a current driving licence? Is it valid for the UK? Do you need a work permit for this post? If you are applying for a UK based post and you are invited to interview, you will be asked to produce evidence of your right to work in the UK. Examples of such evidence include NI card/Passport/Birth Certificate/P45/Payslip. (This is in accordance with the Asylum & Immigration Act 1996). If you are invited to interview and have special requirements because for example, of a disability, please contact us beforehand to discuss. Please give details of any unspent convictions. A conviction will not necessarily exclude you from employment with Oxfam, but will be taken into consideration when assessing your suitability for this particular position. No

Referees
Give details of two people who have knowledge of you in a working environment, paid or unpaid. (One referee must be your most current/recent manager). If you currently work, or volunteer, for Oxfam or have done so in the past, give your current/last Oxfam manager. Your current manager will only be contacted with your permission. If you are a recent student give appropriate school or college referees. 1 NAME: ADDRESS: E-MAIL: POSTCODE: TELEPHONE: TELEPHONE: 2 NAME: ADDRESS: E-MAIL: POSTCODE:

Can references be taken up now with:

Relationship to you
Your first referee: Yes/No

Your second referee: Yes/No

Declaration
I agree that any offer of employment with Oxfam is subject to satisfactory references and medical assessment if required. (Please note that for all international assignments staff, accompanying partners and children, will automatically be required to undergo a medical assessment). I agree that Oxfam may hold and use the information about me contained in this application, including any information which falls within the definition of sensitive personal data under the terms of the Data Protection Act 1998, for the purposes of processing this application and for personnel reasons if an offer of employment is made. If on this occasion no offer is made I agree that Oxfam may keep a record of my application for 12 months. I confirm that the information on this form and any attachments is correct and complete. I understand that any information later discovered to be incorrect may result in the termination of any agreements made.

Signatu re

.................................................

Dat e

......................................................

Qualifications and TrainingApplication: (continued) Equal Opportunities Monitoring application. Equal Opportunities Date of to the Form Policy Statement Full Name: Please give details of your education, qualifications and training relevant
Reference No:

Oxfams Equal Opportunities Policy

Dates Qualification/Course completed Places of Education/Training Grades/Result Date of Birth: objectives stated overleaf in in order that Age: Oxfams basic Our is effective we need to From Equal Opportunities Policy is are outlined and 'Oxfam, anit Interpretation'. They are Tothat: certain information. Your co-operation is sought in providing this. The information will obtain our Equal Opportunities Policy. This form will be of treated in the strictest confidence and will

be useddid the Human Resources Departments for the purposes of ensuring the effectiveness Where by you see this post advertised?

Oxfam believes You are under no obligation to complete this form but be detached before shortlisting. in the essential dignity of people and if Are you an their capacity to Data Protection Act problems and pressures Oxfam volunteer? Yes No you do you are agreeing, under the overcome theAre you an Oxfam may hold and use 1998, that Oxfam staff member? Yes No personal information about whichmonitoring purposes. If you are not offered employment you for can crush or exploit them. with Oxfam your application may be kept for up to twelve months and then destroyed. This belief is reflected Application for:

How would only within Oxfams International not you describe yourself?

programme, but

also within our work in the UK. recommended by the UK Commission for Racial These categories of ethnic origin are In deployer of volunteers, we aim to ensure that all job applicants, staff and volunteers, do not suffer Asian or Asian unfair discrimination because,Black or example, of their race; colour; for Black British: British: nationality; ethnic origin or religious belief; social class or caste; age; disability; sexual Indian orientation (including lesbians Black gay men); marital status or family and Caribbean situation; or gender.
Pakistani Black African Equality as the most appropriate for monitoring the UK. We recognise however that the specified current legislation, as an employer is staff, and as a line withcategories may not be appropriate for everyone. If thisof the case please use the last box.

We aim to ensure that all people with whom we work are valued for their Bangladeshi Any other black background contributions and are given the opportunity to realise their full potential within (Please specify) the organisation.
Any other Asian background (Please specify) Recruitment, selection and

other procedures try to ensure that individuals are given equal opportunity in recruitment,Chinese or other ethnic training and promotion, and are treated White: group: on the basis of their relevant abilities and merits according to the requirements of the White British job. Where appropriate, particular attention will be paid to the Chinese recruitment of people with disabilities and continuing the employment of, and/or White Irish arranging for the training for, Any other ethnic background employees who have become disabled whilst workingwhite background Any other for Oxfam. (Please
specify) (Please Oxfam specify) is committed to

Mixed:

a programme of action to make the policy effective and to this end constantly reviews the procedures and guidelines which underpin the policy and monitors the results as appropriate. nature of your Do you consider yourself to Yes If yes, what is the There when nationality or family have to be taken into account, for example, during civil or other war, or when a balance of national and expatriate staff has been agreed for particular countries. Any such Gender: Femal exceptions will occur only after careful Male consideration in the light of the needs of e the programme and will be subject to review as circumstances change. Subject only to such situations, the principles of equal opportunities will apply to recruitment, promotion, transfer, training and all terms and conditions of employment. There are variations between the detail of conditions for staff working in different countries, but these will be within the framework of the Staff Charter, and follow the underlying philosophies for Oxfam adapted to local contexts rather than a radical departure from them. Oxfam believes that following a policy of equality of opportunity will benefit not only the individual but also benefit and enrich the whole organisation.
have a disability/impairment? may be occasions No disability/impairment?

Please use this section to indicate how far you meet each of the competencies required for the post. List experience, achievements, knowledge, personal qualities and skills which you feel are relevant, against each competency. You may include paid and unpaid work, work within the home and leisure interests.

Achievements, Personal Qualities & Skills (continued)