Home-Start in Suffolk Job application form 06/22

Thank you for taking the time to apply for a role with Home-Start in Suffolk.

Should you require any assisstance in completing this form please contact sarah@homestartinsuffolk.org or call 01473 621104

Please note that any field with an asterisk is mandatory, should the question not be applicable please note N/A in the answer.
Position applied for*
Name:*

PrefixLast NameMiddle NameFirst Name
Home phone number:

Area CodePhone Number
Mobile Number:*
E-mail Address:*
Address:*

Street Address

Street Address Line 2

City

Post code
If you have lived at your current address for less than 5 years please add previous address(s)

Street Address

Street Address Line 2

City

Post code
Previous addresses continued...

Street Address

Street Address Line 2

CityCounty

Post code
Do you hold a current driving licence?*

YesNo
Do you have access to the use of a vehicle?*

Yes- CarYes- Public transportNo

References Please give the names and addresses of two referees who must not be related to you or a member of your household.   One must be your current or most recent employer.  We will only contact your referees if we make you a conditional offer.

Reference 1
Name:*

First NameLast Name
Job Title:
In what capacity are they known to you?*
Phone Number*

Area CodePhone Number
Years Known:*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 2
Name:*

First NameLast Name
Job Title:
Phone Number*

Area CodePhone Number
In what capacity are they known to you?*
Years Known:*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Education*

	Subjects	Qualifiations gained	Grade/level
1
2
3
4
5
6
7
8

Job related qualifications/specialised training *

	Course title and qualification achieved (if applicable)	Grade if applicable

1
2
3
4
5
6

Present or most recent job *

	Please complete
Job title
Name of Employer
Date started
Date finished
Salary
Notice period

Purpose of job*

Previous employment, most recent first *

	Employer	Job title	From	To	Brief description of duties	Reason for leaving
1
2
3
4
5
6
7
8

Please tell us about any voluntary or unpaid work, starting with most recent

	Organisation	Role	From	To	Brief description of duties	Reason for leaving
1
2
3
4

Please tell us about gaps in your employment history, starting with the most recent with reasons e.g. career break to look after children or other dependents, travelling, training or education. *

	From	To	Reason
1
2
3
4

Are you related to any person who works in a paid or unpaid capacity for Home-Start?*

YesNo
If offered this position, do you intend to continue working in any other capacity? *

YesNo

Relevant skills, knowledge and experience*

Please use this page to show how you meet each of the essential criteria in the person specification and what evidence you have to show you have the ability to undertake the role as described in the Job description. Please structure your statement adopting the key headings of the person specification.  Max 500 words0/500

Are you eligible to work in the UK?*

YesNo
If no to the above please give details
CONFIDENTIALITY

During the course of their work, staff will be aware of information concerning the Charity’s activities, its staff, volunteers and other personal information relating to children and their families. I understand that this is confidential information must not be used for any purpose other than the performance of duties and must not be divulged to unauthorised persons, nor used for the production of articles, books etc. without the Charity’s specific agreement.

YOUR DATA

All of the information collected in this form is necessary and relevant to the performance of the job applied for. We will use the information provided by you on this form, by the referees you have noted, the educational institutions with whom we may undertake to verify your qualifications with and any criminal record checks for recruitment purposes only. Home-Start in Suffolk will treat all personal information with the utmost confidentiality and in line with current data protection legislation.

Should you be successful in your application, the information provided, and further information which will be gathered at the relevant time, will be subsequently used for the administration of your employment.

For more information on how we use the information you have provided, please see our privacy notice
I confirm that the information given on this form is correct and that I have not knowingly withheld any material fact. Under the Data Protection Act 2018, I hereby consent for the information in this application form, about myself and others, to be processed by Home-Start in Suffolk for the purposes of recruitment. I hereby give my permission to those individuals or organisations contacted for the purpose of this background check to give their full and honest evaluation of my suitability for the described role and other information as they deem appropriate *

Clear
Name*

First NameLast Name
Date*

DayMonthYear
Date
For successful applicants this application form will subsequently be held on their personnel file, and those who are unsuccessful, it will be held for a maximum of 6 months and then destroyed.

Please read the following information carefully before signing and submitting your application.

The post you are applying for is ‘exempt’ from the Rehabilitation of Offenders Act 1974 and therefore, you are required to declare any convictions, cautions, reprimands and final warnings that are not ‘protected’ (i.e. filtered out) as defined by the Rehabilitation of Offenders Act 1974. The amendments to the Exceptions Order provide that certain ‘spent’ convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service/Citizens Advice website. Further information can also be found on the Nacro website

Disclosure of criminal records will be requested from Disclosure and Barring Services to assist with decision making for this role.
Please note: A criminal record will not necessarily be a bar to an applicant obtaining a position.
A copy of the following policies are available on request: the Home-Start in Suffolk- Ex-Offenders Policy, the Code of Practice and the Home-Start In Suffolk Policy on Handling Disclosure information.
Do you have any convictions, cautions, reprimands or final warnings that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order (as amended)?

YesNo
Are you, or have you ever been the subject of fitness to practice proceeding by a UK or overseas licensing regulatory body?

YesNo
If you answered yes to any of the above, please disclose the details under separate cover via email to sarah@homestartinsuffolk.org

Please mark your email as CONFIDENTIAL and clearly state your name and the details of the post in your email.
Name

First NameLast Name
Signature

Clear

Should be Empty: