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
Positive Behaviour Support Worker
Training and Compliance Officer
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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
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 Qualification
If you answer 'yes' to either of the below, you must provide a certificate or other evidence of completion.
Do you have an NVQ/QCF level 2 (or above) in Health & Social care?
*
Yes
No
Have you completed the care certificate (England only)?
*
Yes
No
Please tell us about any other relevant formal qualifications you have achieved (including any maths or English qualifications)
When did you leave full time education?
*
-
Day
-
Month
Year
Date
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Part Four – Your Work History
We are required by law to make sure we know about the work you have done in the past, as well as the periods you may have spent out of employment. Therefore, please list your full employment history here, including any periods when you were not working (along with an explanation of what you were doing). Please email us at finance@apspirepc.co.uk if you do not have enough space.
*
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
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Part Five – Your Referees
Please provide the details of three people that we can write to for a reference. The first of these people must be your current or most recent employer. The other referees should ideally be from any previous Health and Social Care roles. Additional references may be required upon request to satisfy Aspire of your past conduct in these roles. If you cannot provide the details of three previous employers, you may substitute one or more of these with a referee who was a former tutor or teacher when you were in formal education. If you cannot provide details of a teacher or tutor, 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)
*
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
Second referee
*
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
Third referee
Details
Referee's name
Position
Name of Organisation, School or college
Address and postcode
Phone
Email
Date of employment or study
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Part six – Criminal Record
Aspire employees work with vulnerable people and we take our responsibility to protect them very seriously. Your appointment will depend on the satisfactory completion of a criminal records disclosure (see policystatement below), but at this stage, we need you to answer the following questions truthfully and honestly
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 our applying for an enhanced criminal recordsdisclosure on you and to our retaining a copy of your disclosure certificateduring the period of your employment or until a new disclosure is completed(whichever occurs first)?
*
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 for the job
Please read the job description and answer the following questions:
Have you read and understood the job description?
*
Yes
No
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) 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 tell us about your skills and experience in this type of work from previous employment, voluntary work or in your own life. We advise that you use the job description and person specification to assist you. Give examples if you think it will help to reflect your experience.
*
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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. 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
*
Clear
Date
*
-
Month
-
Day
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
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:
Submit
Should be Empty: