Candidate Registration Form Candidate Registration Form 21.2021 Personal InformationPersonal Information* Title DrMissMrMrsMsProf.Rev. First Name Surname Right to Work in the UKNationality* Type of Visa (if applicable): Start date: DD slash MM slash YYYY Working weeks remaining: End date DD slash MM slash YYYY Disability AdjustmentsDisability Adjustments*Do you have any disabilities which a future employer could make reasonable adjustments for? Yes No Disability Adjustments - Yes detailsIf yes, please provide details: Where did you hear about Totum?Where did you hear about Totum?*Please confirm the source of your application to Totum: GAAPWeb LinkedIn Reed Total Jobs Totum Website Other Recommendation/Referral Other (please specify)Other (please specify) Recommendation/Referral (please specify)Recommendation/Referral (please specify) Candidate DeclarationsThe information you provide will be treated in confidence and only provided to clients when requested. Convictions*Do you have any unspent criminal convictions AND/OR previous/current driving bans? Yes No CONVICTIONS - Yes detailsIf yes, please provide details: County Court Judgements*Have you had any County Court Judgements against you in the last 5 years? Yes No COUNTY COURT JUDGEMENTS - Yes dateIf yes, please provide expiry date: DD slash MM slash YYYY DECLARATIONI hereby confirm that the information that I have given above and have supplied on my CV is complete, correct and true. By putting my name and the date on this form, I confirm that my personal data may be held and disclosed by Totum for the purposes and matter set out in their GDPR/Privacy Policy. I confirm that I am happy for them to store my information for the purpose of finding me a new position and for them to send me correspondence and marketing information. I also confirm that whilst I may not actively seeking a new role at present that I am happy for them to send me correspondence and marketing information. (https://www.totumpartners.com/privacy-statement-and-cookies-policy) Candidate Name:* Candidate Email:* Date:* DD slash MM slash YYYY Our Commitment to EqualityTotum is committed to supporting equality of opportunity and works towards ensuring that everyone we work with has access to all of our products and services. Understanding the diversity of any “talent pool” is vital in achieving this aim. If we find we are not sourcing or meeting certain types of candidates/backgrounds then we can try and do something about it. Please be assured that your participation in this exercise is purely voluntary and in no way will the information you provide be linked to your application. We analyse completed forms on a periodic basis, report these to our clients and try to learn from the results. Thank you for your participation if you choose to complete this form. If you have any questions or concerns, the consultant you are meeting will be pleased to discuss these with you.Ethnic BackgroundPlease describe your ethnicity Age Groups 16-24 25-34 35-44 45-54 55-64 65+ Prefer not to say Employment StatusAre you employed? Yes No Prefer not to say Gender Male Female Prefer not to say Prefer to self describe Self Describe GenderPlease describe Sexual Orientation Bisexual Gay man Gay woman Heterosexual / straight Other Prefer not to say DisabilityThe Equality Act 2010 generally defines a disabled person as someone who has a mental or physical impairment that has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities. a) Do you consider yourself to have a disability according to the definition in the Equality Act? Yes No Prefer not to say 6. Disability2b) Are your day-to-day activities limited because of a least problem or disability which has lasted, or is expected to last, at least 12 months? Yes, limited a lot Yes, limited a little No Prefer not to say Religion or belief No religion/belief/Atheist Buddhist Christian Hindu Muslim Sikh Any other religion Jewish Prefer not to say Employment Functional area (if employed) BD & Marketing Human Resources Finance IT General Management Prefer not to say Change & Transformation Projects Measuring socio-economic background* We take diversity and inclusion seriously and as part of Totum’s commitment to D&I we collect and report on data given by candidates who sign up with Totum on areas including ethnicity, age, gender, sexual orientation and disability. We have decided to further our commitment by asking the following socio-economic questions. Socio-economic background is defined by the highest earning parent’s occupation, according to the National Statistics Socio-economic Classification (NS-SEC). *Socio-economic background is the term to refer to the particular set of social and economic circumstances that an individual has come from. It permits objective discussion of the influence of these circumstances on individuals’ educational and career trajectories; and it can be objectively measured by capturing information on parental occupation and level of education.What was the occupation of your main household earner when you were 14? Traditional professional occupations such as: accountant, solicitor, medical practitioner, scientist, civil/ mechanical engineer Senior managers and administrators usually responsible for planning, organising and co-ordinating work and for finance such as: finance manager, chief Modern professional occupations such as: teacher/lecturer, nurse, physiotherapist, social worker, welfare officer, artist, musician, police officer Technical and craft occupations such as: motor mechanic, fitter, inspector, plumber, printer, tool maker, electrician, gardener, train driver Middle or junior managers such as: office manager, retail manager, bank manager, restaurant manager, warehouse manager, publican Clerical and intermediate occupations such as: secretary, personal assistant, clerical worker, office clerk, call centre agent, nursing auxiliary, nurse Small business owners who employed 25 or less; corner/retail shop owners, small plumbing companies, single restaurant or cafe owner, taxi/garage owner Routine manual and service occupations such as: HGV driver, van driver, cleaner, porter, packer, sewing machinist, messenger, labourer, waiter / waitress Semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant Long term unemployed (claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year) Retired Don’t know / not applicable Prefer not to say Did either of your parents attend university? (by the time you were 18) Yes, one or both of my parents attended university No, neither of my parents attended university Resources Do not know / not sure Prefer not to say Δ