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Personal Details and Information





Additional Information


Criminal Record Declaration

The nature of the work you are applying for is exempt from the provisions of the Rehabilitation of Offenders Act 1974. If you are applying for a post involving access to persons in receipt of care services, your offer of employment will be subject to a satisfactory enhanced Disclosure and Barring check. It is therefore a requirement that all previous convictions are declared, even those which would otherwise be regarded as ‘spent’. (Any such information will be treated confidentially).

Please read the above carefully and then answer the following questions:


Education, Training, Qualifications and Current Learning


Employment History

Make sure to fully describe your employment history from leaving education to the present day. If there were any gaps in employment, please explain when and why.


Relevant Experience


General Availability


References

Please provide the names and contact details of referees. The first two must be your present or most recent employers, if there is less than two years between both of these then please provide a further reference.

We will not contact any referee without your permission or until an offer of employment has been accepted. If you do not have three employment references, one may be from a professional body, a lecturer or teacher or similar. Also, if you have previously been employed in a position which involved working with vulnerable adults or children for more than three months then one of the references you provide must be from this agency/employer. (In accordance with the Health and Social Care Act 2008).

Personal referees such as relatives, friends, neighbours etc ARE NOT acceptable as referees

Most Recent Employer

Past Employer

Past Employer


Application Declaration (Please read carefully before submitting the application)

The information in this form is true and complete. I agree that any deliberate omissions, falsification or misrepresentation on this form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. This equally applies to any medical questionnaires I may complete.

I confirm that I have not been subject to any cautions or convictions (other than those given above), investigation, disciplinary action, or enquiry into adult/child protection matters or inappropriate behaviour, and that the information I have given in the Criminal Record declaration section is to the best of my knowledge correct.

If you have not received any correspondence within 14 days then please assume on this occasion you have been unsuccessful, and your application form will be kept on file for 6 months.