Employment Application Form
We are committed to safeguarding and promoting the welfare of children. All applicants must complete safer recruitment process, including checks with past employers and an enhanced level DBS. All applicants must answer all questions with no omissions. Failure to disclose information may result in offer of employment being withdrawn. We are an equal opportunities employer.
Post Applying For:
*
Closing Date (If Known):
Name
*
Title
First Name
Last Name
Date of Birth:
-
Day
-
Month
Year
Date
Have you ever been known by a different name:
*
Yes
No
*If so, please state here:
Address
*
House Name/ Number
Street
City
County
Post Code
From:
-
Day
-
Month
Year
Date
Have you lived at this address for the last 5 years: (If no, please provide last 5 years address history below)
*
Yes
No
Address:
Address
Street Address Line 2
City
State / Province
Post Code
Date From:
-
Day
-
Month
Year
Date
Date To:
-
Day
-
Month
Year
Date
Telephone:
*
example@example.com
Email:
*
example@example.com
National Insurance No:
*
How did you hear about the position?
*
Website
Indeed
LinkedIn
Other
CV - Upload your CV here
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you have any form of relationships with other employees?
*
Yes
No
Will this be your only job role if successful?
*
Yes
No
Do you have the right to work in the UK?
*
Yes
No
Yes (Temporary)
Have you spent more than a 3 month period overseas in the past 10 years? (Aged 18+)
*
Yes
No
Do you hold any qualifications relevant to the post you are applying for?
*
Yes
No
Qualification
Please Select
Level 3 Diploma (Childrens Residential Care)
Level 4 Diploma (Childrens Residential Care)
Level 5 Diploma (Leadership & Management)
Social Work Qualification
Other
Additional Details:
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 Details Below)
No
Have you had 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?
*
Yes (Please Provide Details Below)
No
Have you ever been dismissed or resigned after disciplinary procedures have been instigated?
*
Yes (Please Provide Details Below)
No
Have you ever had any safeguarding concerns raised against your name include anything that resulted in no further action made?
*
Yes (Please Provide Details Below)
No
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 Details Below)
No
Any other information that you want to disclose or discuss?
*
Yes (Please Provide Details Below)
No
Additional Details:
DBS & Criminal Information
All care roles 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 Provide Details in Disclosure Information
No
Have you ever received a Caution or Warning?
*
Yes - Please Provide Details in Disclosure Information
No
Are there any alleged offences outstanding against you?
*
Yes - Please Provide Details in Disclosure Information
No
Do you currently have an in date, valid DBS on the update service?
*
Yes - Please Provide Details in Disclosure Information
No
Employment & Reference Information
We must have full employment history for all roles paid, unpaid or any other type of role since the age of 16 years old. We reserve the right to request information from any caring role as part of safer recuritment 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:
*
Position Held:
*
From (DD/MM/YYYY):
*
To (DD/MM/YYYY):
*
Referee Name:
*
Referee Position:
*
Referee Email (Work Email):
*
Referee Telephone (Work Telephone):
*
Reason for Leaving:
*
Previous Employment:
*
Position Held:
*
From (DD/MM/YYYY):
*
To (DD/MM/YYYY):
*
Referee Name:
*
Referee Position:
*
Referee Email (Work Email):
*
Referee Telephone (Work Telephone):
*
Reason for Leaving:
*
Do you have any additional employment history relevant to this application?
*
Yes - Please Provide Details Below
No
Do you have any recent gaps in employment history?
*
Yes - Please Provide Details Below
No
Additional Details:
Education/ Qualifications
Please include all educational achievements
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Qualification
Date Achieved (MM/YYYY)
Driving Status
Do you hold a valid UK driving licence?
*
Manual
Automatic
No
Do you have any current endorsements (Points)
*
Yes
No
Driving Licence Number:
Licence Issue Date:
-
Day
-
Month
Year
Date
Licence Expiry Date:
-
Day
-
Month
Year
Date
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 you have gained
Please provide your supporting statement below:
*
Employee Declaration
Declaration for all applicants applying for employment
I declare the information on the above application is true and accurate.
*
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
Signature
*
Date DD/MM/YYYY:
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