Application for Employment

Please use BLACK ink when completing this form.

Completed application forms should be returned to:

Hibiscus Initiatives

Holloway Resource Centre,

356 Holloway Road

N7 6PA

Email Address:

Telephone Number: 020 76974120

Personal Details
Surname: / Forename(s):
Title:
Other names you have been known by: / Home Telephone No:
Address:
Postcode: / Work Telephone No:
Mobile Telephone No:
Applicants with disabilities:
In case you are invited for an interview and you need any adjustment to attend please let us know.
Please specify: / Start date: If appointed, how much notice are you required to give to your current employers?
Email:

SECTION 1: TO BE COMPLETED BY THE APPLICANT

You may continue any section on a separate sheet but please provide the appropriate heading and please include your name on any additional sheets.

Post Details

Position applied for: ______

How did you hear of the vacancy (If advertised please state the name of the publication): ______

Are you looking for Full-time / Part-time / Temporary? Please specify ______

Education & Training
Secondary Education:
Name of School/College / Dates
From / To / Exams Taken / Grade / Date obtained
Further / Higher Education:
College/University / Dates
From / To / Exams Taken / Grade / Date obtained

Please continue on a separate sheet if necessary

Professional Memberships & Registration
Name of Professional Body / PIN Number/Membership Number / Expiry date (if applicable)

Professional Memberships & Registration

Please give details of all training undertaken in order of the most recent first:
Date / Training / Expiry date (if applicable)
Please list any special interests you have that might be relevant to the post you are applying for:
Current Recent Employer
Name & address of Employer:
Job Title: / Dates Employed:
From: To:
Current or final salary: / Period of notice required:
Reason for leaving (or seeking other employment):
Please give a brief outline of your main responsibilities:
Previous Employers – Most recent first
Name & address of Employer / From / To / Post Held, Grade & Main Duties / Reason For Leaving
Relevant work experience (unpaid) or Volunteering experience
Name & address of Employer:
Job Title: / Dates Employed:
From: To:
Please give a brief outline of your main responsibilities:
Supporting Statement
Please summarise why you would like to apply for this position and why your skills and experience meets the role’s requirements. Please relate your response to the job description and person specification provided.

Please continue on a separate sheet if necessary, writing your name and job applied for at the top.

Rehabilitation of Offenders Act 1974

Disclosures

The Rehabilitation of Offenders Act 1974 outlaws discrimination against ex-offenders. It is intended to help people with few and/or minor convictions.

Certain criminal convictions are 'spent' (forgotten) after a rehabilitation period. This period varies according to the offence. For people aged 18 or over when convicted:

·  convictions resulting in sentences such as fines, compensation and community service become spent after one year

·  prison sentences of six months or less become spent after two years

·  prison sentences of over 6 months and up to and including 30 months become spent after four years

·  prison sentences of over two and a half years, up to and including 4 years become spent after seven years

·  Sentences over 4 years are never spent.

Most rehabilitation periods are halved if you were under 18 when convicted.

You don't need to disclose spent convictions when applying for most jobs but because of the nature of work done by Hibiscus Initiatives, in prisons and immigration detention centers, we do have the right to ask for this information.

Depending on the job, employers can request that successful applicants apply for different types of disclosure:

·  Basic Disclosure — an employer can request this for any job (even jobs not exempt under the Rehabilitation of Offenders Act). This contains only details of unspent convictions.

·  Standard Disclosure is for jobs with regular contact with children or vulnerable adults and jobs exempt from the Rehabilitation of Offenders Act. This shows all convictions, including spent ones.

Enhanced Disclosure is for jobs with greater (unsupervised) contact with children or vulnerable adults and for some judicial appointments and licensing purposes. This shows all convictions, including spent ones, plus possibly other information from local police records

Additional Personal Details

Do you have any unspent convictions? Yes No

Do you have any spent convictions? Yes No

If yes please give details

Do you have any charges pending for any criminal offences? Yes No

If yes please give details

Have you ever been refused employment or Yes No

any other opportunity on the basis of disclosure?

Do you consent to the above information being checked by Yes No

the Disclosure and Barring Service (DBS)?

Have you lived in the UK for the last five years? Yes No

Are there any other matters relating to character that you think we should know? Yes No

Right to work in the UK

It is illegal to employ someone who has not been granted leave to enter or remain in the UK, who has no right to work in the UK, or no right to do the work being offered. With effect from 29 February 2008, the Immigration, Asylum and Nationality Act 2006 has introduced a new system whereby an on the-spot civil penalty can be imposed for employers who have negligently employed an illegal worker. This provision can also relate to volunteers too.

Yes No

Are there any restrictions on you taking up employment in the UK?

Do you need a work permit to take up employment in the UK? Yes No

References

We will not take up references unless we propose to offer you the post and will inform you first. All offers of employment are subject to provision of satisfactory references, enhanced DBS checks and specific checks related to the post you are applying for. One Reference is expected from your current or most recent employer

Name / Name
Job Title / Job Title
Name of organisation / Name of organisation
Address / Address
Contact tel
Contact fax
Contact email / Contact tel
Contact fax
Contact email
How long have you known this person and in what capacity? / How long have you known this person and in what capacity?
Declaration

I declare that the information contained in this application is complete and correct. I understand that if I have knowingly provided false information, given misleading statements or withheld relevant details this could lead to the withdrawal of an offer or subsequent disciplinary action, which could lead to dismissal.

Data Protection Act, 1998 - I agree that the information I have supplied can be stored on computer or held manually in accordance with the Data Protection Act.

I consent to Hibiscus Initiatives (and their professional advisers) using and keeping information I have provided on this application form or elsewhere as part of the recruitment process and/or personal information supplied by third parties such as referees, relating to my application or future employment.

I understand that the information provided will be used to make a decision regarding my suitability for employment and if successful the information will be used to form my personnel record and will be retained for the duration of my employment. If I am not successful, I understand that Hibiscus Initiatives will retain the form for 6 months after which time it will be destroyed. I agree that Hibiscus Initiatives may contact me in the event of there being any other vacancies for which I may be suitable. We do continue to keep anonymous information for monitoring purposes principally to comply with anti-discrimination legislation.

Signed Date

Thank you for taking the time to give us the information requested.

This form must be emailed to or sent in hard copy to

Hibiscus Initiatives, Holloway Resource Centre, 356 Holloway Road N7 6PA

Hibiscus Initiatives is a registered charity number 1104094
and a company limited by guarantee registered in England no 4533442