Job Application Form - Almond Care Children’s Services

Application Details

Application for the post of:(Required)

Have you previously applied for a position in our organisation? (Please select)(Required)

If you have, please tell us the role you applied for and the date of application:

Personal Details

Title: (Please select)(Required)

If Other, please specify

Surname:(Required)

Forename(s):(Required)

Previous Names (if applicable):

Date of birth:(Required)

Home Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Daytime Contact Number:(Required)

Evening Contact Number:

Email Address(Required)

Are you free to take up employment in the United Kingdom?(Required)

If yes, my National Insurance number is:

If no, are you subject to immigration control?

Driver Information

Do you hold a current, full driving licence?(Required)

If NO, do you hold a provisional licence?

If applicable, please list any points and/or driving convictions including dates:

Vocational

Do you hold any of the following qualifications?

Are you a qualified teacher?(Required)

If yes, what is your DfES no.:

NVQ / QCF Level 3 Diploma for the Children's and Young People's Workforce(Required)

NVQ Level 4 HSC (CYP Pathway) plus Registered Managers Award(Required)

QCF Level 5 Diploma in Leadership for Health and Social Care, Children and Young People's Services(Required)

Details of any Membership of Professional Bodies:

Working Practices

Please complete as appropriate (only complete if you are applying to work in our residential care homes)

Are you available to work 24-hour shifts including sleep-ins?

Are you available to work weekends and bank holidays?

Are you available to work flexibly and demonstrate a high level of commitment?

Are there any limitations on your ability to work flexibly?

If No - what are they?

Are there any limitations if you were asked to extend your shift?

Do you / will you have any other employment if you came to work for Almond Care Children's Services?(Required)

If yes please give details:

Education, Qualifications and Training

Education, Qualifications and Training(Required)

Course Title

Qualification (i.e. NVQ / GCSE etc)

Place of Study

Date (Start date and Completion date)

Employment History

Please begin with the most recent, giving details of any gaps in employment and the reasons for these. Full history is required - from leaving secondary education to the present. Please include months and years for all appointments.

Employment History

Name and Address of Employer

Job Title and Brief Outline of Duties

Dates From - To (Month and year are required)

Salary and Reason for Leaving

Reasons For Applying(Required)

Please include your achievements to date, any relevant knowledge, skills and experience and strengths you would bring to the role.

Leisure Interests(Required)

Please detail any leisure interests, sports and hobbies or other pastimes.

References

Please include below the name, status, address and telephone number of two referees, one of whom must be your current or most recent employer.

If you are applying for a post which requires unsupervised access to children, the company reserves the right to approach any past employer for a reference. Information requested will include details of your past performance, absences, disciplinary records, reason for leaving and suitability to work with children and young people.

Current / Most Recent Employer and Name of Line Manager

Name and position:

Telephone Number:

Mobile Number:

Email Address:

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employer and Name of Line Manager

Name and position:

Telephone Number:

Mobile Number:

Email address:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Information

Before completing this section please read this:

The post for which you are applying is exempt under the provision of the Rehabilitation of Offenders Act 1974 by virtue of the Exceptions Order 1975 (Amendment) (England and Wales) Order 2013.

This means you must give full details of any criminal conviction, including any spent convictions, or pending circumstances that might lead to prosecution, conviction, bind-over or caution.

The disclosure of a criminal record, or other information, will not necessarily debar you from appointment. In making this decision Almond Care Children's Services will consider the nature of the offence, how long ago and what age you were when it was committed. Also any other factors which may be relevant can be given consideration, including considerations in relation to the company's equality policies.

Any information you give will be treated in confidence

Do you have any criminal convictions, bind-over or cautions in respect of any offence?(Required)

If Yes, please give details:

If you have none, please state "I have no convictions, cautions or pending court cases"

Are you subject to any current or oustanding disciplinary procedures, or have you ever had action taken against you by an authority regarding children under 18 years old? If so, please give details.

Applicants need to be aware that Almond Care Children's Services carries out a disclosure on all people we decide to appoint. Information received from the DBS will be kept in strict confidence.
Failure to declare a conviction, caution, or bind-over may, however, disqualify you from appointment, or result in summary dismissal if the discrepancy comes to light

"I take notice that if I have any convictions and do not declare them, or withhold information which is relevant to my application, or if information provided in my application is untrue, I understand I will be instantly dismissed.
I confirm that I have read, understood and have truthfully answered the above questions and that everything else in this application (including any additional pages) is, to the best of my knowledge, accurate and correct."

Do you hold a current DBS Certificate, dated within a year?(Required)

If YES please complete the following:

Issue date:

Certificate No.:

Countersignature Details:

Print Name:

Date

PRIVATE & CONFIDENTIAL

Equality & Diversity

Almond Care Childrens Services is an equal opportunity employer. The aim of the policy is to ensure no job applicant, employee or worker is discriminated against either directly or indirectly on the grounds of race, colour, ethic or national origin, religious belief, political opinion or affiliation, sex, marital status, sexual orientation, gender re-assignment, age, or disability. Our recruitment criteria and procedures are frequently reviewed to ensure that individuals are selected, promoted and treated on the bases of their relevant merits and abilities.

All employees are given equal opportunity and are encouraged to progress within the organisation.

We are committed to an on-going programme of action to make this policy fully effective.

You ensure that this policy is fully and fairly implemented and monitored, and for no other reason, would you please provide the following information which will be detached from the rest of your application and retained by the H.R. Department before shortlisting.

Gender

Are you:

Ethnicity

Are you:

Disability

Under the Equality Act 2010 (Disability) Regulations 2010 a person is considered to have a disability if he/she has a physical or mental impairment which has a sustained and long-term adverse effect on his/her ability to carry out normal day-to-day activities. Do you consider yourself to be a disabled person?

Sexual Orientation

How would you describe your sexual orientation?

Religious Beliefs

What is your religious belief?

Other Beliefs (please specify):

Marital Status

How would you describe your marital status?

Data Protection Act 1998(Required)

This form will be detached and will not be seen by the selection panel. Information in this application will be kept confidentially by Almond Care Children's Services and used for the exclusive purposes or recruitment and employment. Once the recruitment and selection process is complete, the data will be stored and used for your personnel records. Please indicate your consent for the information to be used in this purpose.

Job Title / Job Applied For:(Required)

Name:(Required)

Date of Birth:(Required)

Signed:(Required)

Date(Required)

Age(Required)

Please enter a number from 0 to 150.