Confidential

ApplicationforEmployment

PostTitle:

Postno:

Service:

Location:

Completedformsshouldbereturnedto:

Human Resources, EastHerts Council,

Wallfields,PegsLane,Hertford,Hertfordshire,SG138EQ

NotestoCandidates

Before completingthisapplicationform,pleasereadtheenclosedGuidancetoApplicantsleaflet.

PleasecompleteALLsectionsofthisform,deletinginformationasappropriate. PleaseuseBLOCKCAPITALSonthispageand writeinblueor blackinkor type.

If anyspaceprovidedis inadequate, pleaseuseasupplementarysheet andattachittothisform.

Post Title:Post no:

Service:Location:

PersonalDetails

Surname:

FirstName:

Address:Title:

NatInsNo:

Daytime TelNo:

Postcode:

EveningTelNo:

Email:

MobileTelNo:

General Information

Doyouhaveacurrentdrivinglicense?YesNoDoyouwishtojob-sharethispost?YesNo

If job-shareorpart-time,pleaseindicate

AreyourelatedtoaCouncilloror

employee of East HertsCouncil?YesNo

If yes,pleaseprovidedetails:

Name:

thedays ortimesofdayyouwouldprefer:

Relationship:

Membership

Pleaseindicatemembershipofprofessionalbodiesrelevanttothisjob.

Nameof organisation / Typeof membership / Dateof membership

Relevant employment history(most recentfirst)

Pleasecontinueonaseparatesheet ifnecessary

Job Title:Reason for leaving:

Employer:Datestarted:

Address:

DateLeft:

Postcode:

Keyrole/responsibilities:

Job Title:Reason for leaving:

Employer:Datestarted:

Address:

DateLeft:

Postcode:

Keyrole/responsibilities:

Job Title:Reason for leaving:

Employer:Datestarted:

Address:

DateLeft:

Postcode:

Keyrole/responsibilities:

References

Pleasegivedetailsoftworeferees,oneofwhichmustbeyour currentormostrecentemployer.

Name:

Name:

Position:

Position:

Address:

Address:

Telephone No:

If youdonotwishthisreferencetobetaken upuntil anofferofemploymentis made, pleasetickbox

Telephone No:

If youdonotwishthisreferencetobetaken upuntil anofferofemploymentis made, pleasetickbox

Educationand Qualifications

Pleasedetailanyqualificationswhicharerelevanttothejoband/orspecifiedontheperson specification.Pleasecontinueonaseparatesheet ifnecessary.

ExaminationBodyi.e. NVQ / Subject / Result

Relevant training

Pleasedetailanycoursesyouhaveattendedwhicharerelevanttothejoband/orspecifiedonthe personspecification.Pleasecontinueonaseparatesheet ifnecessary.

OrganisingBody / Course Title / Year

Experience, skillsand other informationinsupportof yourapplication

Pleasedetailexperience andskills whichdemonstrateyour abilitytocarry outthisjoband/or specifiedonthepersonspecification.Pleasecontinueonaseparatesheet ifnecessary.

Consent and declaration of details

Informationsuppliedonthisapplicationformwillbeused tomonitortheeffectiveness ofEastHerts policiesandpractices,in particularitsEqualOpportunitiesPolicy.Thismonitoringis forstatistical purposesonly andyour namewillnotbeidentifiablefromthisprocess.Tohelp us effectivelymonitor theEqualOpportunitiesPolicy,wealsoask youtocompleteourmonitoringform.Thisis a confidentialdocumentused foranalytical purposesonly. Itis detachedfromyour applicationby Human Resourcesbeforeitis senttotherecruitingdepartment.

InaccordancewiththeDataProtectionAct,applicationformsofunsuccessfulcandidateswillbe destroyedafter one yearfromthedatethepostis appointedto.

•Ideclarethattheinformationcontainedin thisapplicationformis correct.

•Ihaveread, signedandreturnedtheenclosedCriminal Declaration formincludedin thepack.

Yourapplicationwillnotbeconsideredwithoutthisform.

Signature:Date:

CVswillnotbeaccepted. Applicantswillberequiredtosigne-mailedapplicationsatinterview

Declarationof Unspent and Spent CriminalOffences

Beforecompleting thisform, please readthefollowingnotes carefully:

EastHerts Policystatesthatsuccessfulapplicantsfornominatedpostshavetodisclosecertain informationonanypreviouscriminalrecordthattheymay hold.Thisdoesnotmeanthatpossession ofacriminalrecordwillautomaticallypreventyoufromworkingwiththeCouncil,rather, aspartof therecruitmentprocesssuchinformationwillonly beconsideredin lightofitsrelevancetothepost forwhichyouareapplying.Inmany cases, aparticularconvictionwillbeofnorelevanceandsocan bediscountedforthepurposesofyour application.Inassessingyour suitabilityforapostthe CouncilcomplieswiththeCodeofPracticerecommendedbytheDisclosureandBarring Service (DBS),acopyofwhichcanbeobtainedonrequest.

Youmustgivedetailsonthisformofanyconvictionsorcautionsyouhaveoranycourtcasesthat youhavepending.Under theprovisionofTheRehabilitation ofOffenders Act1974, jobapplicants do nothavetodiscloseinformationoncertainconvictionsafter asetperiodoftime,i.e.when they become‘spent’.Thenominatedpostshavebeenidentifiedafter ariskassessment andanapplicant willbeadvisedwhichlevelofdisclosureis required.Theeligibilityguidancecanbeviewedon

•Standardchecks–Tobeeligible foraStandardlevelDBScheckthepositionmustbeincluded in theRehabilitation ofOffenders Act(ROA)1974 (Exceptions)Order1975.

•Enhancedchecks–Tobeeligible foranEnhancedlevelDBScheck,thepositionmustbe includedin boththeROAExceptionsOrderandin Police ActRegulations.

•EnhancedcheckswithChildren’sand/orAdults’Barredlistcheck(s)–Tobeeligible torequest acheckoftheChildren’sorAdults’Barredlists,thepositionmustmeet thenew definitionof RegulatedActivity.Thereareasmall numberofotherpositionsforwhichwecanalso request listchecks.

Wherethepostappliedforinvolvesworkingwithchildrenorvulnerableadultsin apositionoftrust asoutlinedbytheDBSweareallowedbyvirtue oftheExceptionsOrdertotheRehabilitation of Offenders Acttorequestapplicantstorevealtheir fullcriminalhistory(including ‘spent’convictions) duetothenatureofthedutiesandresponsibilitiesoftheposition.

OnlythosepositionsthatrequireEastHerts toask anexemptedquestionareeligible toapplyfora disclosure.TheCouncilwillusetheinformationprovidedbytheDBSwhen assessingyour suitability forsuchjobs.Intheevent ofemploymentbeingoffered,anyfailuretodisclosesuchconvictions couldresult in dismissal ordisciplinaryactionbytheCouncil.Anyinformationyougivewillbekept confidentialandwillonly beconsideredin relation tothejobforwhichyouareapplying.Thereforeif youhavebeenconvictedofacriminaloffencein then past(including anyconvictionsin acourtof law outsideGreatBritain)youmustgivedetails(convictions,dateandsentence)below.

Declarationof CriminalOffences

Using theguidelines, pleaselistallyour unspentandspentcautionsandcriminaloffences. Do notforgettoincludeanypendingconvictionsandindicatethattheyarepending.

Ifyouhavenoconvictionsplease write‘None’ and signtheform. Ifyouhaveanyqueries about thecompletion of theform, please contactHuman Resources.

Natureof Offence(s) / Nameof Court and Dateof Conviction / Sentence(s)

Allinformationwillbetreatedin thestrictestconfidence.Followingreceiptofthisformyoumay be contactedtodiscusstheinformationyouhavegiven.

Icertifytothebestofmyknowledge,theinformationonthisformis trueandaccurate.

IunderstandthatiftheinformationIhavesuppliedis false,misleading orincompletein anyway,

itmay automaticallydisqualifyme fromtheappointmentormay renderme liabletoinstantdismissal withoutnotice.

Please completethisform and return it withyourapplication to:

Human Resources,East HertsCouncil, Wallfields,Pegs Lane, Hertford,SG138EQ

Signed:

Date:

Name(PleaseprintinCAPS):

Post AppliedFor:

PolicyStatementontheRecruitment of Ex-offenders

•Asanorganisationusing theDisclosureandBarring Service(DBS)toassessapplicants’suitability forpositionsoftrust,TheCouncilcompliesfullywiththeDBSCodeofPracticeandundertakes to treatallapplicantsforpositionsfairly. Itundertakes nottodiscriminateunfairly against any

subjectofaDBScheckonthebasis ofaconvictionorotherinformationrevealed.

•TheCouncilis committedtothefair treatmentofitsstaff,potentialstafforusersofitsservices, regardlessofrace, gender, religion, sexualorientation,responsibilitiesfordependants,age, physical/mentaldisabilityoroffendingbackground.

•Thiswrittenstatementontherecruitmentofex-offenderswillbemade availabletoallDBS

applicantsattheoutsetoftherecruitmentprocess.

•TheCouncilactivelypromoteequalityofopportunityforallwiththerightmixoftalent,skills andpotentialandwelcomeapplicationsfromawiderangeofcandidates,includingthose withcriminalrecords. TheCouncilselectallcandidatesforinterview basedontheir skills, qualificationsandexperience.

•ADBScheckis only requestedafter areviewoftheJobDescription;wherethereviewindicates thatoneis bothproportionateandrelevanttothepositionconcerned. Forthosepositionswhere aDBScheckis required,allapplicationforms,jobadvertsandrecruitmentdetailswillcontaina statementthataDBScheckwillberequestedin theevent oftheindividualbeingofferedthe position.

•WhereaDBScheckis toformpartoftherecruitmentprocess,theCouncilencourages all applicantscalledforinterview toprovidedetailsoftheir criminalrecord. Thisinformationshould beprovidedonthemonitoringformandtheCouncilguaranteethatthisinformationwillonly be seenbyManpowerandHuman Resources.

•UnlessthenatureofthepositionallowstheCounciltoask questionsaboutapplicant’sentire criminalrecord,theCouncilwillonly ask about‘unspent’convictionsasdefinedin the Rehabilitation ofOffenders Act1974.

•TheCouncilensuresthatallthoseinvolved in theappropriaterecruitmentstages havebeen suitablytrainedtoidentifyandassesstherelevanceandcircumstancesofoffences. TheCouncil providesstaffwiththeappropriateguidanceandtrainingin therelevantlegislation relating tothe employmentofex-offenders,e.g. theRehabilitation ofOffenders Act1974.

•TheCouncilwillensurethatanopenandmeasureddiscussiontakes placeonthesubjectofany offencesorothermattersthatmightberelevanttotheposition. Thisdiscussionwillbeleadby the ChairoftheInterview PanelandHuman Resources.Failuretorevealinformationthatis directlyrelevanttothepositionsoughtcouldleadtowithdrawalofanofferofemployment,advice willbesortfromtheDBS.

•TheCouncilmakes everysubjectofaDBSawareoftheexistence oftheDBSCodeofPractice andcanmake acopyavailableonrequest.

•TheCouncilundertake todiscussanymatterrevealedin aDBScheckwiththepersonseeking thepositionbeforewithdrawingaconditionalofferofemployment.

Havingacriminalrecordwillnot necessarilybaryoufromworking withus.

Thiswill dependon the natureofthe positionandthe circumstancesandbackgroundofyouroffences.