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  Invigilator Application Form - Feb 2015 __________________________________________________________ 

Personal details

Surname: Title (circle as appropriate): Nationality: Date o birt!:

  Miss Ms Mrs Mr Dr 

Other 

  _ _ / _ _ / _ _ 

Da / Month / Year 

Fir"t name#"$: %en&er (circle as appropriate): Fir"t language: Date o application:

  Male Female _ _ / _ _ / _ _  

Day / Month / Year 

'ontact &etail": (!one number)": A&&re"": *mail a&&re"":

  Work:

Home:

Mobile:

 

Education/qualifications ( &etail" o e&ucational an& proe""ional +ualiication" in c!ronological or&er  $

,ualiication 'ollege ear %ra&e

 

Employment history  ( covering no more than 10 years, starting with the most recent including any gaps in employment)

Date #From ) To$: *mployer: Full time )(art time:

Dutie":

 

Current Employment etails!

Name . A&&re"" o current*mployer 

"f you are currently engaged in full time employment, will the termsof your employment permit you to ta#e up the assignment$ (Circleas appropriate)

  e" ) No

%ave you informed your employer of your request to ta#e up theassignment and o&tained consent! (Circle as appropriate)

  e" ) No

E'perience as an invigilator or freelance staff for any recognised e'ams (national and international)

Date #From ) To$: Sub/ect ) Sc!eme: *amining ) ali&ating bo&y:

 

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eference detailsPlease provie etails o!  t!ree re!erees incl"in# yo"r c"rrent or most recent employer or most recent acaemic re!eree$ (lea"enote t!at you cannot u"e relative" or rien&" !o reerre& you or t!i" /ob an& are alrea&y invigilator" it! u"3

Name

4ob title ) (o"ition

Telep!one

*mail

A&&re""

Name

4ob title ) (o"ition

Telep!one

*mail

A&&re""

Name

4ob title ) (o"ition

Telep!one

*mail

A&&re""

upporting statement %n s"pport o! yo"r application& an re!errin# to the role pro!ile& please tell "s in ' ors& hy yo" are s"itable !or this role&!oc"sin# on the re*"ire "ill"6 nole&ge an& eperience as mentione in the role pro!ile$

+"pportin# statement

 

Declaration%& $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$& +/o $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$& resiin# at the above #iven aress o herebyeclare that the in!ormation herein !"rnishe by me is tr"e to the best o! my knole#e an % have not s"ppresseanythin# ith re!erence to the etails so"#ht$% a#ree to share a bona !ie copy o! the obtaine consent !rom my employer "pon re*"est$% have no intention o! takin# the %,-.+ test in the net '0 months$ % have no plans to "nertake any similar invi#ilation!or any other or#anisation or en#a#e in trainin# %,-.+ caniates$

Warning: if you include any details that you know to be false or if you withhold relevant information, you may renderyourself liable to disqualification from the recruitment exercise or, if appointed, to dismissal.

Yo"r si#nat"re/name Date

N37 Typing your name ill be taen a" being a" bin&ing a" your "ignature