DEWIS APPLICATION FOR EMPLOYMENT
Post Applied for: Young Person’s Support Worker
SPECIAL REQUIREMENTS
Because this position involves working with young people and/or vulnerable adults employment is dependent on the following:
- Your written consent to us obtaining a satisfactory enhanced DBS Certificate
- Provision of Identity/Right to Work documentation
- Two satisfactory written references.
- Access to your own vehicle.
PERSONAL DETAILS
Title: Mr/Mrs/Miss/Ms(please circle as appropriate)
Surname:
Forename(s):
NI Number:
Address:
Post Code:
Telephone Number:
Email Address:
Date when free to take up appointment:
Current driving licence? Yes/No
Details of any endorsements:
EDUCATION DETAILS
Please give details of your qualifications including where and when they were obtained:
Name of School/College/University:
Dates from/to:
Qualifications obtained:
Name of School/College/University:
Dates from/to:
Qualifications obtained:
Name of School/College/University:
Dates from/to:
Qualifications obtained:
Name of School/College/University:
Dates from/to:
Qualifications obtained:
RELEVANT TRAINING COURSES ATTENDED
Please give details of relevant training attended/qualifications obtained:
Trainer/College:
Dates from/to:
Course Title/Qualification:
Trainer/College:
Dates from/to:
Course Title/Qualification:
Trainer/College:
Dates from/to:
Course Title/Qualification:
OTHER EMPLOYMENT
Please give details of any other employment you would continue with if you were to be successful in obtaining this position:
PREVIOUS EMPLOYMENT
Please give details of previous employment, starting with the most recent:
Employer’s name:
Address:
Job title/duties:
Employed from/to:
Salary: £
Reasons for leaving/wishing to leave:
Employer’s name:
Address:
Job title/duties:
Employed from/to:
Salary: £
Reasons for leaving/wishing to leave:
Employer’s name:
Address:
Job title/duties:
Employed from/to:
Salary: £
Reasons for leaving/wishing to leave:
VOLUNTARY EXPERIENCE
Please give details of any relevant voluntary experience:-
Organisation:
Dates from/to:
Brief description of duties:
Organisation:
Dates from/to:
Brief description of duties:
INTERESTS
Please give brief details of your hobbies, interests and membership of any voluntary organisation.
REHABILITATION OF OFFENDERS ACT 1974
(Exceptions under 1975)
BECAUSE OF THE NATURE OF THE WORK FOR WHICH YOU ARE APPLYING, THIS POST IS “EXEMPT” FROM THE PROVISIONS OF THE REHABILITATION OF OFFENDERS ACT 1974 BY VIRTUE OF THE REHABILITATION OF OFFENDERS (EXEMPTION ORDER 1975). APPLICANTS ARE THEREFORE NOT ENTITLED TO WITHOLD INFORMATION ABOUT CONVICTIONS WHICH FOR OTHER PURPOSES ARE “SPENT” UNDER THE PROVISIONS OF THE ACT. IN THE EVENT OF EMPLOYMENT ANY FAILURE TO DISCLOSE SUCH CONVICTIONS WILL RESULT IN DISMISSAL. ANY INFORMATION GIVEN WILL BE COMPLETELY CONFIDENTIAL AND WILL BE CONSIDERED ONLY IN RELATION TO ANY APPLICATIONS FOR POSITIONS TO WHICH THE ORDER APPLIES.
PLEASE LIST DETAILS, eg DATE, TYPE OF OFFENCE, SENTENCE/FINE IMPOSED etc.
Are there any restrictions on you taking up work in the UK? Yes/No
(If yes please provide details)
REASONS FOR APPLYING FOR THIS POST
In your own words, please state why you have applied for this job and the qualities you feel you can bring to it. Your reasons should take full account of the job description enclosed with this form. Please continue on a separate sheet if necessary.
REFERENCES
Please give the name of TWO referees, to whom you are not related including one from your current or most recent employer. Referees of short-listed candidates will not be approached prior to interview.
Name:
Email address:
Telephone number:
Relationship to applicant:
Name:
Email address:
Telephone number:
Relationship to applicant:
DECLARATION
- I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.
- Should we require future information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor. I agree that the organisation reserves the right to require me to undergo a medical examination. In addition, I agree that this information will be retained in my personnel file during employment and for up to 6 years thereafter and understand that information will be processed in accordance with the Data Protection Act.
- I agree that should I be successful in this application, an application to the Disclosure Barring Service will be made. I understand that should the disclosure not be to the satisfaction of the organisation any offer of employment maybe withdrawn or my employment terminated.
Signed:
Date:
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