Application Form
Position applied for:
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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Education
Education
Education
Education
Professional Qualification/Memberships (please include expiry date, if applicable).
Are you currentlyregistered with the Scottish Social Services Council (SSSC)?
Yes
No
If yes, please insert your registration number below:
Work Related Development/Courses
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Employment History
Please give details of ALL past employment, excluding your present employment,stating the most recent first. Please give a brief explanation to any gaps inemployment, if there are unexplained gaps it could affect the application beingconsidered – continue on a separate sheet if necessary.
Present or most recent employer
All Previous Employment
All Previous Employment (continued)
All Previous Employment (continued)
All Previous Employment (continued)
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of
All Previous Employment
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References
Please provide the names of two referees, one of which should be your present or most recent employer. If you do not want your referees to be contacted before the interview, please let us know.
Reference 1
*
Contact before interview?
*
Reference 2
*
Contact before interview?
*
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Full Driving Licence
*
Endorsements
*
If yes, please provide full details:
Are you involved in any activity which might limit your availability to work, or your working hours?
*
If yes, please provide full details:
It is a criminal offence for barred individuals to apply to work with vulnerable groups in a regulated activity. Are you on a barred list?
*
Have you any convictions, including both spent and unspent convictions under the Rehabilitation of Offenders Act 1974? (A copy of the Company’s Equal Opportunities Policy and Disclosure Information Policy is available on request. These reflect the CRB/Disclosure Scotland Codes of Practice).
*
If yes, please provide full details:
Have you ever worked for our company before?
*
If yes, please provide full details:
Have you applied for employment with Ben View before?
*
Do you need a work permit to take up employment in the U.K?
*
Do you have any medical conditions which could affect your ability to work?
*
If yes, please provide full details:
How much notice are you required to give your current employer?
*
Do you consider yourself to have a disability? (We ask for this information so that we can offer an interview to all applicants who have a disability and meet the minimum criteria for this position).
*
If yes, please provide full details:
Do you have any holidays arranged?
*
If yes, please provide dates:
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Interests, Achievements and Leisure Activities (e.g. hobbies, sports, club memberships).
*
Please provide us with any other information that will support your application.
*
Information In Support of Application – Person Specification Please detail here how you meet the requirements of the person specification. When completing this section, please provide examples of when you have demonstrated the skills and qualities outlined in the person specification.
Declaration
I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable to summary dismissal. I understand these details will be held in confidence by the Company, for the purposes of on-going personnel administration and payroll administration in compliance with any changes to the above details. Given the nature of the job for which I have applied, I understand that any offer of employment will be subject to information on my criminal record being disclosed to the company by the Criminal Records Bureau/Disclosure Scotland. I have been given a copy of the information relating to the recruitment of ex-offenders.
I agree with the above statement.
Signature (typed)
First Name
Last Name
Date
-
Day
-
Month
Year
Date
Submit
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