Any sections that aren’t applicable, please write N/A

01. Your Details

Your Next of Kin Details

02. Education, Qualifications and Experience

Please give details of any Mandatory Units / Training courses attended

What kind of work are you experienced in?

Employment History (last 3)

If you have any other employment history, please submit these details at interview stage

03. Transport

Driver’s Licence

04. Referees

References are usually followed up for candidates selected for interview. Please give full contact details of two work related referees. One of the referees should be your employer, or if presently employed/self-employed, your last employer.

Referee One

Referee Two

05. Other

06. REHABILITATION OF OFFENDERS ACT

As a general rule, no-one need disclose details of spent convictions. However, this general rule does not apply to specified professions, employments and occupations. By virtue of Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Orders, the exemption rule does not apply to:

  1. Any employment or other work which is concerned with the provision of health services and which is of such a kind as to enable the holder of that employment or the person engaged in that work to have access to persons in receipt of such services in the course of his normal duties, or
  2. Any employment or other work which is concerned with the provision of care services to vulnerable adults and which is of such a kind as to enable the holder of that employment or the person engaged in that work to
  3. Have access to vulnerable adults in receipt of such services in the course of his normal duties

One or more of the above apply to work with the agency and covers all occupations.

You are therefore requested to provide details of all convictions, including those which would otherwise be considered as “spent”. All employment applications will be considered carefully, and the disclosure of a conviction does not imply that this employment application will be rejected.

Records will be checked via the Criminal Records Bureau procedures

07. Criminal Records - Disclosure Certificate

Disclosure Barring Service (DBS) have issued a Code of Practice regarding Disclosure information, a copy of which is available upon request. A Disclosure Certificate (Standard or Enhanced) will be requested from the CRB which will detail all convictions, including those which would otherwise be ‘Spent’ as well as details of Cautions, Reprimands or Final Warnings. You will be advised of the type of Certificate being requested and asked to give your approval to this application. The Disclosure Certificate will only be requested in the event that you are successful in your application for employment

Under the Rehabilitation of Offenders Act 1974, as a general rule, no-one need answer questions about Spent convictions.

All Employment Applications will be considered carefully, and the disclosure of a conviction does not imply that this employment application will be rejected.

Please submit basic details of any convictions you may have. Additional information may be disclosed at interview stage or an office member of staff may contact you to discuss this further

08. Supporting Information

Give details of any supporting information which you would like to include to back up your application. Such information, for example, may include skills and/or achievements which you think may be of interest, and/or a summary of why you believe that you have the qualities we are looking for. Please provide details of any relatives employed by the agency and their relationship to you.

09. Asylum and Immigration Act 1996

Under Section 8 of the Asylum and Immigration Act 1996 it is a criminal offence to employ a person aged 16 or over who is subject to immigration control unless:

  • That person has current and valid permission to be in the United Kingdom and that permission does not prevent him or her from taking the job in question. Or
  • The person comes into a category specified by the Home Secretary where such employment is allowed

Any employment offered will be subject to the successful applicant producing appropriate evidence that the Asylum and Immigration Act is not being contravened.

10. Data Protection Statement

The personal information (data) collected on this form and on the attachments (which includes the collection of sensitive personal data) are collected for the purposes of recruitment, personnel administration (for new employees) and monitoring. Unless you direct otherwise (for example in a situation where you would like this Application kept on file for future vacancies) the Application Forms (and attachments) of unsuccessful applicants will be destroyed after 6 months. It is the policy of the Agency to protect and keep secure, all personal data collected. All personal data is processed for the purposes of recruitment and in the case of successful Applicants, for the satisfactory administration of their employment and for no other purpose.

11. Equality of Opportunity Statement

The Agency’s Equal Opportunities Policy covers all employees or potential employees and embraces the principle that all people shall be treated equally, regardless of their age, gender, ethnic origin, nationality, colour, religion, marital status, sexual orientation, religion or belief, disability or offending background.

12. Personal Declaration

I declare that to the best of my knowledge the above information, and that submitted in any accompanying documents, is correct, and

  • I give permission for any enquiries that need to be made to confirm such matters as qualifications, experience and dates of employment, and for the release by other people or organisations of such information as may be necessary for that purpose,
  • I give permission for the processing of the personal data contained in this form for employment purposes
  • I understand that any false or misleading information could result in my dismissal.