Application Form

Application Form
Thank you for your interest in applying to work for Lavender Grove Cares.

As part of our safer recruitment process, you will need to complete the following application form in full.

Applications not completed in full will not be progressed.

If your application is successful, we will be in touch to arrange an interview.

If you have any questions about our recruitment process, or careers at Lavender Grove Cares, please contact us on recruitment@lavendergrovecares.co.uk | Tel. 01277887225 Option.4
Vacancy Details
Position you are applying for*
Location *
Where did you hear about this vacancy?

Personal Details
Forename*
Surname*
Previous Names (if applicable)
Date of Birth*

DayMonthYear
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Home Telephone Number*
Mobile Number *
National Insurance Number*

About You

Select the statements that are true for you
Driving License*

I hold a FULL UK driving licenseI do not hold a FULL UK driving license
DBS*

I hold an enhances DBS certificate for a child workforce and it is recorded on the DBS update serviceI hold an enhanced DBS certificate for a child workforce, however it is not recorded on the DBS update serviceI do not hold a current enhanced DBS certificate for a child workforce
Shift Work*

I am able to work shift work, including evening, weekends and occasional sleep in'sI am not able to work shift work
If successful, when can you start your position?*
Do you have any planned leave? If YES, please record dates below*

Interview Arrangements
Are you subject to any conditions relating to your employment in this Country?*

YesNo
If "YES", please tell us what these conditions are?
Do you require us to make any adaptations for your interview to accommodate any disability you may have?*

YesNo
If "YES", please tell us what these should be?

Education & Employment History
Education - Please list your education history, including months/years and qualifications you gained*
(Example: 01/05/2000 - 01/06/2010 | School/College | Qualifications Gained)
Training & Development
List any training or development courses you have completed, that maybe relevant to the role. Include dates and length or courses.
Employment History (including dates, reasons for leaving and any gaps)*
List in chronological order your employment history since leaving education. It is important that you include dates from and to and reasons for leaving. If you have any gaps in your employment history, include these too (i.e May 2019 - Aug 2019 | Job Seeking). Note: If there are any errors in recording on this section, you will be asked to rectify this before moving forwards in the process.

References

Please provide details of at least 2 references, one of these must be your most recent employer. We will not contact referees until you have successfully passed your interview and received a conditional offer of employment. (Note: We may also request references from any previous employer where you have worked with vulnerable children/adults).
Reference 1

This must be from your most recent employer
Name of Employer*
Address of Employer*
Role of Employer*
Relationship to you*
Telephone Number*
Email Address*
Permission to request reference*

YesNo
Reference 2
Name of Employer*
Address of Employer*
Role of Employer*
Relationship to you*
Telephone Number*
Email Address*
Permission to request reference*

YesNo

Convictions & Disqualifications
A criminal record will not necessarily be a bar to obtaining a position at Lavender Grove Cares.

If a check is returned and reveals any information, this will be discussed with the applicant.

Under the Rehabilitation of Offenders Act 1974 (exemptions) order 1975, spent convictions and/or cautions must be disclosed.

Please provide details below if you have been convicted of a criminal offence or have been the subject of a conditional discharge or probation order. (Past criminal proceedings are not necessarily an obstacle

to taking up a post. This occurs only where the offence/s is/are deemed relevant. Any details will be discussed with you should you be the successful candidate based on your supporting statement, interview, and tests).

For the full policy on this matter please contact the HR team at Lavender Grove Cares.
Declaration*

I have no convictions, cautions or pending court casesI have conviction(s), caution(s) or am awaiting the outcome of a criminal court case
If you have conviction(s), caution(s) or are awaiting the outcome of a criminal court case - please provide full details below

Regulated activity with children, young people or adults - Declaration
The following declarations are only required if you are applying to undertake regulated activity with children, young people or adults with care and support needs. If you are in doubt about this requirement, please refer to the job description.
Declaration*

I confirm that I have not been barred from working with children by DBS, the Independent Safeguarding Authority (ISA) or any other organisationI confirm that I have not been barred from working with adults with care and support needs by the DBS, Independent Safeguarding Authority (ISA) or any other organisation
If you currently belong to a professional body / organisation, please include full details below:

Skills, Knowledge, Ability & Experience
Please use this section to demonstrate why you feel you would be suitable for the position, referring to the job description and person specification, giving examples and case studies where possible. It is important to include all relevant information, whether this has been obtained through formal employment, volunteering, caring for a dependant or engaging in leisure activities.
Education & Qualification *
Knowledge*
Skills / Attributes / Abilities *
Experience*

Declaration
Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered.

By submitting this application, I confirm that the information given in this application is, to the best of my knowledge, correct. I understand that any offer is subject to receipt of satisfactory references. I fully understand that if subsequently any information given is found to be false or misleading, Lavender Cares reserves the right to withdraw its offer of employment or cancel any agreement made. I understand that if this is discovered at a later date, my employment may be terminated.

I have read and accept the conditions above.

If you apply a position with Lavender Grove Cares we will use the information you provide to assist in the recruitment and selection process. Under the General Data Protection Regulation (GDPR) 2018, the general information that you supply about yourself is known as your personal data. This includes information about any criminal convictions, ethnic origin, and health amongst other things; and these are classed as ‘sensitive personal data’.

We will process (e.g., record and use) your personal and sensitive personal data for our internal records, in the context of equal opportunity monitoring and to assist in the selection process for employment. Generally, we will only use your information within Lavender Grove Cares Ltd.

However, sometimes we use third parties to process your information on our behalf. Lavender Grove Cares requires these third parties to comply strictly with our instructions and they do not use your personal information for their own business purposes unless you have explicitly consented to the use of your personal information in this way.

Your personal Information will be retained only for as long as necessary to fulfil the purposes for which the information was collected, or as required by law.

Further information on your rights and our responsibilities on processing your personal information can be found on our website. If you have any queries or requests at any time concerning your personal information held by us or our practices in this regard, please contact us on info@lavendergrovecares.co.uk
I have read and accept the conditions above. I also confirm that information recorded in my application form is factual and accurate to the best of my knowledge.*

First NameLast Name
Date*

DayMonthYear
Should be Empty:

Application Form

Vacancy Details

Personal Details

About You

Interview Arrangements

Education & Employment History

References

Reference 1

Reference 2

Convictions & Disqualifications

Regulated activity with children, young people or adults - Declaration

Skills, Knowledge, Ability & Experience

Declaration