POP Employment Application Form

Employment Application Form

We are committed to safeguarding and promoting the welfare of children and vulnerable adults. All applicants must complete the safer recruitment process, including checks with past employers and an enhanced level DBS. Applicants must answer all questions with no omissions. Failure to disclose information may result in the offer of employment being withdrawn. We are an equal opportunities employer.
Job Role*
Role Location*
Prefix*
Name*

First NameLast Name
Have you ever been known by a different name or title*

YesNo
Please provide previous name(s)?*
Date of Birth*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
National Insurance Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Have you lived at the same address for the last 5 years?*

YesNo
Move In Date*

DayMonthYear
Date
Please provide 5 year address history including dates (or put n/a)*
CV - Upload your up to date CV here *

Cancelof
Do you have a personal relationship with an existing employee of Place of Progress?*

YesNo
Will this be your only job if successfully appointed?*

YesNo
Do you have the right to work in the UK?*

Yes - permanentYes- temporaryNo
Have you spent more than 3 months aboard in the last 5 years?*

YesNo
If you answered "yes" please provide details*
Are you qualified for the role you are applying for?*

YesNo
Qualification*
Safer Recruitment Questions
Have you ever been subject to any investigation, fact findings, disciplinary action or dismissed from paid, unpaid, voluntary, other employment, training or other programme with children, young people and/or vulnerable adults that was either substantiated or unsubstantiated?*

Yes - please provide detailsNo
Have you have any disciplinary action against your name? Depending on the reason for the warning, we may have to write to the relevant company to confirm the action that was taken.*

YesNo
Have you ever been dismissed or resigned after disciplinary procedures have been instigated?*

Yes - please provide detailsNo
Do you have any medical conditions or illness that may impact on your ability to care for children and young people including if required to use physical intervention if this was need to protect a child or young person from harm*

Yes - please provide detailsNo
Is there any other information you would like to disclose?*

Yes - please provide detailsNo
DBS & Criminal Information

All roles with vulnerable children, young people and adults are exempt from the Rehabilitation of Offenders Act. You must disclose both spent and unspent convictions during the selection process. Failure to disclose information may disqualify your application or result in dismissal without notice.
Do you have any criminal convictions or cautions against your name? Please detail all convictions/cautions, including the dates*

Yes - Please detail all convictions/cautions, including the datesNo
Have you ever received a Caution, Reprimand or Warning?*

Yes - Please provide details in the Disclosure InformationNo
Do you have a valid Enhanced DBS on the update service?*

YesNo
DBS certificate number*
Issue date on certificate*

DayMonthYear
Date
Employment and Reference Information

We must have full employment history for all roles paid, unpaid or any other type of role since the age of 18 years old. We reserve the right to request information from any caring role as part of safer recruitment checks. Please provide details of all roles since leaving school. Failure to disclose information may disqualify your application or result in dismissal without notice.
Current or most recent employment*
Previous Employment 1*
Previous Employment 2*
Previous Employment 3
Previous Employment 4
Previous Employment 5
Do you have any employment gaps?*

YesNo
Please explain all gaps in employment that are longer than 4 weeks*
Education

Please provide us with your complete education history, starting with the most recent. Also use this section to record any current studies that you are undertaking.
Supporting Statement

Please explain how you meet the requirements outlined in the Person Specification. You should give examples from previous paid, unpaid employment including any transferable skills gained
Please provide your supporting statement*
Declaration
I declare that the details on this application form are true to the best of my knowledge*

Yes
I agree to you approaching any of my previous employers to verify my employment history and I understand that all conditional offers of employment are subject to satisfactory recruitment checks. If we are not satisfied, or unable to verify safer recruitment checks we reserve the right to withdraw any conditional offer of employment.*

Yes
I agree that, if I am appointed, the information may be used as part of the personnel record of my engagement under GDPR regulations.*

Yes
I understand that if I give false information or withhold relevant information it could result, in termination of employment.*

Yes
Full Name*
Date*

DayMonthYear
Date
Should be Empty:

Employment Application Form

Safer Recruitment Questions

DBS & Criminal Information

Employment and Reference Information

Education

Supporting Statement

Declaration