Application Form
Part One - Your Personal Details
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
NI Number
*
Driving Licence Number
Email
*
example@example.com
Job Role Applying for?
*
Support Worker
Team Leader
Service Manager
Receptionist Administrator
Quality Assessor Support Worker
HR Advisor
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Part Two - Your Availability
It is really important to us that we know when you are available for work so please do your best to ensure that the information youprovide in this section is correct.
What is the earliest date you could start work with us?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Do you have any holidays etc... booked?
*
Yes
No
Dates of Holidays etc... booked
Do you use your own vehicle for work?
*
Yes
No
Is there anything else we should know about your availability?
*
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Part Three - Your Skills and Qualifications
If you answer “Yes” to either of the questions below, you will be required to bring the original certificates to your interview.
Have you completed Oliver McGowan on Learning Disability and Autism – Tier 2 – within the last 3 years?
*
Yes – completed within the last 3 years
Yes – completed more than 3 years ago
No
Have you completed the Level 2 Accredited Care Certificate (2025 onwards)?
*
Yes
No
Please tell us about any other relevant formal qualifications you have achieved (including any maths or English qualifications)
When did you leave secondary education?
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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Part Four – Employment History
Please provide full employment history in chronological order since leaving secondary education, including periods of any post-secondary education/training, and part-time and voluntary work as well as full time employment, with start and end dates.IMPORTANT NOTE: When providing reason for leaving, for each role, please confirm that you were not under investigation for or subject to any disciplinary sanctions in relation to your conduct at the time of leaving/dismissal. If you were, please provide details
Please ensure any periods of overseas residence are also reflected within your employment, education and address history where applicable.
*
Rows
From (month & Year)
To (month & Year)
Employer & location (or educational establishment) and contact details
Your role (or, if studying, your course)
Why you left (if applicable)
Start with the date you left school
2
3
4
5
6
7
8
9
You must end with your most recent employer
Have you lived outside the United Kingdom for a total period of six months or more since the age of 18?
*
Yes
No
Overseas residence details
Rows
Country
From date
To date
Address or brief details
1
2
3
4
5
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Part Five – Your Referees
Reference details are only required for your most recent employer plus any health and social care roles. Additional references may be required upon request to satisfy Aspire of your past conduct in these roles. If you do not have any employment history we can accept details of a teacher or tutor, or we may accept a personal reference from a person of professional standing (eg. a doctor, lawyer, accountant, recognised religious leader or teacher) who knows you, either professionally or personally. You must not give the names of friends or relatives or colleagues that are / were not senior to you as referees. All references will be verified.
First referee (should be current or most recent employer)
*
Rows
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
Second referee
*
Rows
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
Third referee
Rows
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
Can you confirm you have provided a full employment history since leaving school and provided all required references?
*
Yes
No
If no, please go back to employment reference section and amend it
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Part six – Criminal Record Checks
We will only ask those candidates who have been selected for interview to complete a criminal record self-declaration form or provide a written disclosure statement, giving them the opportunity to provide sufficient information. At interview, or in a separate confidential discussion, we will ensure that an open and measured discussion takes place regarding any offences that may be relevant to the position.We will only carry out Disclosure and Barring Service (DBS) checks on successful candidates at the appropriate level for the role applied for.As part of our safer recruitment process, applicants will also be asked to declare any periods of residence outside the United Kingdom since the age of 18. Where a candidate has lived outside the UK for six months or more, Aspire may require an overseas criminal record check, police clearance certificate, certificate of good character, or equivalent documentation from the relevant country or countries. This will be undertaken in addition to any DBS checks required for the role.Where an overseas criminal record check is unavailable, cannot reasonably be obtained, or obtaining it would be disproportionate or impractical, Aspire will undertake a documented risk assessment and seek alternative assurances, which may include enhanced scrutiny of employment history, verification of conduct through references, and investigation of any gaps in employment history.Failure to provide accurate and truthful information, including details of overseas residence, is considered a serious matter. If it becomes apparent that inaccurate or incomplete information has been provided, we will need to establish why. Any finding of deliberate misrepresentation, omission of relevant information, or intent to deceive may result in an application being disqualified or, if appointed, disciplinary action being taken and/or dismissal.
Have you received any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013 by SI 210 1198)?
*
Yes
No
To your knowledge, are you currently the subject of any criminal proceedings (for example, charged or summoned but not yet dealt with) or any police investigation?
*
Yes
No
If you answered ‘yes’ to either of the two previous questions, please provide details:
Do you consent to Aspire undertaking the appropriate Disclosure and Barring Service (DBS) check and, where applicable, obtaining or requesting overseas criminal record checks or equivalent documentation in support of its safer recruitment processes?
*
Yes
No
Note that if, once a criminal records disclosure has been completed, it is discovered that you have failed to accurately disclose the information requested above, the company reserves the right to terminate your employment without notice. Please be aware, however, that your having a criminal record will not necessarily mean we cannot employ you – if you would like to know more about our policy on the recruitment of ex-offenders, please ask. Criminal records disclosures –our policy. As an organisation assessing applicants’ suitability for positions which are included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order using criminal record checks processed through the Disclosure and Barring Service (DBS), we comply fully with the Code of Practice and undertake to treat all applicants for positions fairly. We will not discriminate unfairly against any subject of a criminal record check on the basis of a conviction or other information revealed. We can only ask an individual to provide details of convictions and cautions that we are legally entitled to know about. Where a DBS certificate at either standard or enhanced level can legally be requested (where the position is one that is included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended) and where appropriate Police Act Regulations (as amended), we can only ask an individual about convictions and cautions that are not protected.
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Part seven – Suitability
The position for which you are applying requires physical effort (including sitting, standing, carrying, walking, moving and handling people), mental effort (including dealing with emergencies and short-notice changes to work in a fast-paced environment) and possible emotional / psychological effort (including dealing with bereavement and challenging behaviour in a potentially stressful environment):
Have you read and understood the job description?
*
Yes
No
Do you have any health conditions that would prevent you from meeting these intrinsic requirements for which the company might need to make reasonable adjustments? (If yes, please be aware that we may need to discuss these with you at your interview)
*
Yes
No
If you answered ‘yes’, please provide brief details:
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Part Eight - Knowledge, Skills and Experience
Please give details of your skills, abilities, experience and personal qualities to demonstrate how you meet the criteria in the person specification, using examples wherever possible.
*
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Part Nine - Declarations
Please read the following statements carefully. If there is anything you do not understand, please ask before you sign at the bottom of the page.
Are you a relative or partner of, or do you have a close personal relationship with any employee of Aspire PC?
*
Yes
No
If yes, please state their full name, post title and place of work
Have you previously been employed or sought employment through Aspire PC?
*
Yes
No
If yes, please provide details
Have you ever been subject to any sanctions being placed on your professional registration, by a regulatory or licensing body in any country? Sanctions may include: Warnings, conditions, limitations, suspension, removal or any other restrictions that have applied to your professional registration. Yes No N/A If yes, please provide details and details of any sanctions
*
Yes
No
N/A
If yes, please provide details and details of any sanctions and, the nameand address of the regulatory or licensing body concerned.
Have you ever been dismissed for misconduct from any employment, volunteering, office, or other position previously held by you?
*
Yes
No
N/A
If yes, please provide details
Have you ever been under investigation for or subject to any disciplinary sanctions in relation to your conduct at the time of your dismissal/leaving any employment, volunteering, office, or other position previously held by you?
*
Yes
No
If yes, please provide details
Signature
*
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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Part Ten – Declarations Continued
Please read the following statements carefully. If there is anything you do not understand, please ask before you sign at the bottom of the page. I, the job applicant named on the front of this form, confirm that the information I have given in this application is accurate and true to the best of my knowledge. I also understand and agree that: The company may make checks to verify the information I have provided; - Providing misleading or false information in this form or at any other time during the application process may disqualify me from appointment or, if I have already been appointed, may result in my dismissal; - The personal information I have provided in this form (and any other personal information that I or my referees may provide) is confidential and will be handled in line with the Data Protection Act 1998; - The company will use the personal information I have provided to decide if I am suitable for the job I have applied for; - Until I am employed, the company will not use my personal information for any purpose other than monitoring its own recruitment processes and that if the company does use my personal information for statistical analysis, it will be anonymised; If my application is unsuccessful, the company will keep only basic information about me and destroy the rest; - If my application is successful, my personal information will be used for legitimate purposes in relation to my work (my contract of employment, which I will sign before I start work, will include further detail on how my information may be used); - The company may process my personal information for the purposes described above or as otherwise permitted or required by law in line with its registration with the Information Commissioner; - Any offer of employment will depend on the receipt of satisfactory employment references and the satisfactory completion of a criminal records disclosure (see part six above); - I will be liable for the cost of my initial criminal records disclosure but that the company will bear the cost of any future disclosures that need to be made; - I will be required to complete a pre-employment induction training programme prior to my starting work with the company;
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional notes
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Equal Opportunities Monitoring Form
To help us check that we are recruiting people in a fair and non-discriminatory way, all job applicants are asked to complete monitoring data about themselves. Please complete the sections below by ticking the appropriate box. This information will be treated as confidential. It will be separated from your application form and will not be seen by any members of the recruitment process. The information will be used solely for monitoring purposes and has no part in any selection process. Data Protection Act 1998: Information given on this form will be entered onto a computer database for the purpose of recruitment administration and equal opportunity monitoring and for no other purposes; this information is secure and is never passed to any third party. Please fill in the details required and / or tick the appropriate boxes. Please leave blank any questions you do not wish to answer.
Name
*
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Marital Status
Married
Single
Separated
Widowed
Living with partner
Divorced
Other
Please select the option you feel most appropriately identifies your ethnic origin.
Please Select
Asian - Bangledshi
Asian - Indian
Asian - Pakistani
Asian - Other
Chinese
Chinese - Other
Black - African
Black - Caribbean
Black - other
White - British
White - Irish
White - Other
Mixed - White and Asian
Mixed - White and Black Caribbean
Mixed - Other
Other - please state
Do you consider yourself to have a disability? (If yes, please provide details)
What is your religion?
Please Select
Christian
Hindu
Spiritualist
Muslim
Sikh
Wiccan
Buddhist
Jewish
No religion
Prefer not to say
Other
How did you hear about this job?
Please Select
Google
Other Website
Refer a friend
Newspaper Advert
Word of mouth
Company Website
Jobcentre
Growth Company
Indeed
How can you prove you are legally entitled to work in the UK? (a copy of this will be required on the day of your interview)
*
Please Select
UK or Irish Passport
UK or Irish Birth Certificate
Right to Work - share code
Please upload the Right to Work Document you selected above (optional):
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