Job Application Form

Job Application Form

CG Partnership is committed to safeguarding and promoting the welfare of adults at risk and/or children and expects all our staff and volunteers to share these values. We are also committed to treating all applicants equally and fairly based on their skills, experience, and ability to fulfil the duties required of the role applied for. Applicants must share with us all the relevant information that we requested in this application form, but we would like to reassure applicants that any information provided will be treated in the strictest confidence in a fair and open manner. Suitable applicants will not be refused employment because of offences or conduct which are no longer relevant, and do not place them at, or make them a risk in- the role for which they are applying. We will ensure that all our recruitment and selection practices reflect this commitment.
Post Applied for:
Portsmouth or Southampton?
Where did you see the post advertised?
Personal Details
Name

First NameLast Name
Full Address

Street Address

Street Address Line 2

CityCounty

Postal Code
Phone Number:
Email Address:
Do you have the Right to Work in the UK?

YesNo
National Insurance Number:

Education

Please include all periods of any post-secondary education or training.

	School/College/University	Dates	Qualifications	Subject/Grade	Full/Part time study
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Professional registration:

	Professional Body	Registration/Membership Level	Date Awarded
1.
2.
3.

Other relevant training or qualifications (Please give details and dates)

Current Employment
Are you currently in employment? (If no, go straight to the next section)

YesNo
Name of employer
Address of employer

Street Address

Street Address Line 2

CityCounty

Postal Code
Current job title:
Start Date:
End Date (if applicable)
Contract type (permanent, temporary etc)
Notice Period:
Salary:
Reasons for leaving:
Key duties:

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.

	Employer's name and address	Dates	Post held and duties	Reason for leaving
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Gaps in employment, education or training history

Please detail each period (of more than four weeks) when you were not in employment or educations.

	From:	To:	Details
1.
2.
3.
4.
5.
6.

Skills and Abilities
Behaviour Management:
Teaching in Diverse Environments:
Youth Support and Development:
Empathy and Understanding:
Commitment to Professional Growth:

Referees

Please provide contact details for at least two referees who are able to comment on your suitability for the job applied for. You are responsible for providing accurate contact details so that referees can be contacted. The first referee MUST be your current or most recent employer (or your course tutor if you are currently in, or have just left, full time education) Professional references will not be accepted from work colleagues who are not authorised to provide professional references in an official capacity on behalf of the organisation, or from people writing solely in the capacity of friends, or from relatives.

	Referee 1	Referee 2
Full Name
Position
Address
Telephone
Email

CGP will seek references on successful candidates, and will approach previous employers for information to verify particular experiences or qualifications. If you are currently working with adults/children at risk (including any conduct related to safeguarding concerns which the penalty is 'time expired') and whether you have been the subject of any safeguarding disciplinary procedure including any referrals to Disclosure and Barring Service (DBS), other professional bodies or the Police.

If you are successful at interview, any offer of employment will be subject to receipt of two satisfactory references and any additional pre-employment checks.

Declarations

Relationships

	Yes	No
Are you a relative or a partner of, or do you have a close personal relationship with any employee of CGP? If yes, please state their full name.
Have you previously been employed or sought employment with CGP? If yes, please provide details.

Right to Work

	Yes	No
Do you require permission to work in the UK? (You will be required to provide evidence of eligibility to work in the UK)

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 to give them the opportunity to provide sufficient information. At interview, or in a seperate confidential discussion, we will ensure that an open and measured discussion takes place on the subject of any offences that might be relevent to the position. We will only carry out criminal record checks with DBS on successful candidates at the appropriate level for the role applied for.

Failure to provide accurate and truthful information 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 serious misdirection or intent to deceive will result in an application being disqualified or, if appointed, disciplinary action being taken and/or dismissal.

DBS barred lists - This post involves working in Regulated Activity under the Safeguarding Vulnerable Groups Act 2006 and is subject to an enhanced DBS with barred list checks (i.e. adults, children or both). It is a criminal offence to apply for or accept a position working with adults at risk and/children if you have been barred from engaging in regulated activity with with the relevant group (i.e. adults, children or both)

	Yes	No	N/A
Are you included in the list of people barred from working with adults maintained by the Disclosure and Barring Service (DBS) under the Safeguarding Vulnerable Groups Act 2006?
Are you included in the list of people barred from working with children maintained by the Disclosure and Barring Service (DBS) under the Safeguarding Vulnerable Groups Act 2006?
If you are not currently barred from working with adults at risk and/children under Disclosure and Barring Service (DBS) under the Safeguarding Vulnerable Groups Act 2006, have you been referred to the Disclosure and Barring Service (DBS) for consideration to be added to one of the barred lists?
If yes, please provide details

Conduct declaration

	Yes	No	N/A
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, suspensions, removal or any other restrictions that have applied to your professional registrations.
If yes, please provide details and details of any sanctions and, the name and 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?
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.
If yes, please provide details

I declare that the information I have given in this application is correct and complete. I understand that any false statements or failure to disclose information requested on this form may result in my application being disqualified or may lead to my dismissal or disciplinary action if appointed.

I understand that if i am appointed, personal information about me may be stored for personnel/employee administrative purposes in accordance with relevant Data protection legislation, including UKGDPR/DPA 2018 and any other UK legislation which supports it.

Our organisation will process the data you give us to determine your suitability for the role you have applied for as part of the recruitment process and the ongoing employment relationship if appointed.

In submitting this form, I give my authority for use of my personal data for the purposes outline above.
Signature

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All information on this form will be treated in strictest confidence and used to process your application for employment. If you are appointed, this application will form the basis of your personal file and information on this may be held in an electronic database. If your application is unsuccessful your details will be kept for a period of 3 months and then destroyed.
Should be Empty:

Job Application Form

Personal Details

Education

Current Employment

Employment History

Gaps in employment, education or training history

Skills and Abilities

Referees

Declarations

Criminal record checks

Conduct declaration