Safer Recruitment Application Form

Safer Recruitment Application Form

To apply for any role with ChaplaincyPlus complete all relevant sections of this form as fully as possible. The information you give will be kept confidential by ChaplaincyPlus, unless requested by an appropriate authority.
Role applied for:*
Please use the role title given on the role description or online vacancy.
Full Name*

First NameLast Name
Birth Date*

DayMonthYear
Current Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Email Address*
example@example.com
Phone Number*
LinkedIn
How did you hear about the role?
Available Start Date

MonthDayYear
Current employment:*
Tell us about your current employment, inc. your area of work, your current job title, and your employer's name and address.
Accessibility requirements:
Please let us know if you have any accessibility requirements and we will make any reasonable adjustments to help you with the recruitment process.

SECTION A: Why ChaplaincyPlus? (for all applicants)
In your own words, tell us why you are applying for a role with ChaplaincyPlus.*
Briefly outline your journey of faith.*
Supporting information:*
Please use this space to inform us of your skills, experience, knowledge, attributes and motivations. You should make reference to the role description and person specification when completing this section.
Referees

Please provide the contact details of two suitable referees.
If the role you are applying for has a Genuine Occupational Requirement (GOR) for the post-holder to be an active and practicing Christian, one reference must be from a current (or most recent) church leader (or equivalent) who has known you for at least 2 years.

If you are applying for a paid position at ChaplaincyPlus, one referee must be the name of a current or most recent employer (or equivalent). Please name a manager or personnel officer, not a colleague.

ChaplaincyPlus reserves the right to make any character enquiries considered necessary as part of the application process, for example from a previous place of worship, employer, or other professional (e.g. teacher/ youth worker).

Referee details*

	Referee 1	Referee 2
Name
Email
Phone number
Relationship to you

SECTION B (for staff and trustee roles only)

If you are not applying for a staff or trustee role, please go to SECTION C on the next page.
Are you related or have any connection with any current ChaplaincyPlus staff or trustees?

NoYes*
*If yes, please provide details:
Have you ever had an offer to work with children, young people or vulnerable adults declined on the basis of suitability and/or risk assessment?

NoYes*
*If yes, please provide details:
Do you have the right to work in the UK?

NoYes
Do you need a work permit to work in the UK?

NoYes*
*If yes, please provide details:

WORK HISTORY: Please tell us about your past and current employment / voluntary work in the table below (most recent first), including employment gaps, covering the last five years.

	Employer name & address	Dates from and to	Role/ title	Brief description of duties & responsibilities	Reason for leaving
1
2
3
4
5

EDUCATION & TRAINING: Please tell us about your formal education history and any relevant training you have received in the table below (most recent first).

	Name of education/ training provider	Dates from and to	Course or qualification title	Result/ level achieved
1
2
3
4
5

SECTION C: DECLARATION (for all applicants)
- I confirm that I have completed all sections of this application form relevant to the role I am applying for.
  - Volunteer roles: Section A and Section C
  - Staff/ Trustee roles: Section A, Section B and Section C
- I confirm that I have completed and returned a Self-Declaration form, separate to this application form, to the ChaplaincyPlus Safeguarding team.
- I confirm that the information I have given is true to the best of my knowledge. I understand that should the information I have supplied be false or inaccurate in any way, ChaplaincyPlus reserves the right to terminate my involvement in the recruitment process or my employment should I later be successful.
Signature*

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Safer Recruitment Application Form

SECTION A: Why ChaplaincyPlus? (for all applicants)

Referees

SECTION B (for staff and trustee roles only)

SECTION C: DECLARATION (for all applicants)