Please ensure all sections are completed in BLACK ink or electronically. This form must be completed even if you are submitting a CV. All information will be treated as confidential.

Position Applied for: / Closing Date:
Where did you learn about this vacancy?

PART A: PERSONAL DETAILS

Title: / First Name(s):
Surname: / Known Name:
(If different from first name)
Any other surname or names used including maiden name:
Current Address: / Home Tel No:
Mobile Tel No:
Email:
Post Code: / National Insurance No:
Do you require a work permit to work in the United Kingdom? Yes / No
Do you hold a valid manual driving licence? Yes / No
You will be required to declare any endorsements and provide a copy of your current driving licence if the job description requires you to drive as a condition of employment.

PART B: EDUCATION & QUALIFICATIONS

Please state the details of any qualifications you have gained as well as details of courses you may currently be studying. If the post requires a particular qualification, you will be asked to produce original evidence at interview if you are shortlisted.

Secondary / Further Education / From / To / Qualification Gained/Subject / Grades

(Please add additional pages if required)

PART C: TRAINING / CONTINUING PROFESSIONAL DEVELOPMENT

Please provide details of any training/development relevant to the post for which you are applying (eg First Aid, Food Safety in Catering, Workplace Safety, Safeguarding, etc).

Title and brief description of course / From / To / Grades

(Please add additional pages if required)

PART D: Membership of Professional Associations or Statutory Body

Organisation Name / Level of Membership/ Role/Registration No. (if applicable) / Registration Date

PART E: EMPLOYMENT HISTORY

Please include full employment history starting with your current/latest employer and work back. Employment should be continuous since first leaving secondary education.

Present (or most recent) employment:

Employer’s Name: / Position held:
Address: / Start Date (dd/mm/yy):
End Date (dd/mm/yy):
(if applicable)
Salary:
Notice period:
Postcode: / Reason for leaving:
(if applicable)
Description of duties:

Previous employment history (most recent first):

Employer’s Name: / Position Held:
Address: / Start Date:
End Date:
Postcode:- / Reason for leaving:
Brief description of duties:
Employer’s Name: / Position Held:
Address: / Start Date:
End Date:
Postcode:- / Reason for leaving:
Brief description of duties:
Employer’s Name: / Position Held:
Address: / Start Date:
End Date:
Postcode:- / Reason for leaving:
Brief description of duties:
Employer’s Name: / Position Held:
Address: / Start Date:
End Date:
Postcode: / Reason for leaving:
Brief description of duties:

(Please add additional pages if required)

GAPS IN EMPLOYMENT

Please indicate and explain any gaps in employment since first leaving secondary education. Include specific dates and be sure to account for all gaps, whatever their length.

Date from: / Date to: / Reason for gap

PART F: PERSONAL STATEMENT

(Please add additional pages if required)

PART G: SUPPLEMENTARY INFORMATION

Are you related to any member of the Senior Management Team or to any individuals involved in the recruitment process? Yes / No
If yes, please state their name and your relationship with them:
Other Employment: If offered a post, would you continue to work in any other capacity?
Yes / No
If yes, please provide brief details of employment including days and hours:

Have you ever been the subject of a formal disciplinary sanction or are you in the process of on-going disciplinary proceedings in your current employment? Yes* / No
Have you been dismissed from any previous employment?Yes* / No
If yes please indicate which employment and specify the reasons for your dismissal:
If you are short-listed for interview the panel will discuss this with you and your current and previous employers.

PART H: DISCLOSURE OF CRIMINAL OFFENCES

Due to nature of the work for which you are applying, the provisions of Section 4.2 of the Rehabilitation of Offenders Act 1974 do not apply (by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975). Applicants are not entitled to withhold information about convictions, cautions, reprimands, warnings or bind-overs which are ‘spent’ under the provisions of the Act. The amendmentsto the Exceptions Order 1975 (2013) provide that certainspent convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken intoaccount. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website.

Should you be successful in the interview and selection process for Foxes Academy Ltd, it will be necessary for an Enhanced Disclosure and Barring Service (DBS) Clearance Check application form to be completed before you take up the post. All appointments will be subject to an Enhanced DBS check, together with a Children’s Barred List Check and an Adult’s Barred List Check for Regulated Activity appointments. A criminal record will not automatically debar you from appointment. The selection panel will consider the nature of the offence, how long ago, what age you were when it was committed, and any other factors that may be relevant. In the event of employment, any failure to disclose such convictions will result in dismissal. Any information you may give will remain strictly confidential and will be considered only in relation to this application.

Have you ever been POVA / CRB / DBS Checked in the past?Yes / No

If yes, by whom?……………………………………………...... Date: …………………......

Are you registered with the online DBS Update Service?Yes / No

Do you have any convictions, cautions, reprimands, or final warnings that are not “protected” as defined by the Rehabililitation of Offenders Act 1974 (Exceptions) Order 1974 (as amended in 2013) by SI 2013 1198. Yes / No

Please provide details of any convictions, cautions, and bind-overs in the table below including dates and places. Please also include any pending prosecutions.

Offence / Date / Sentence

I declare that the information given on this form is complete and accurate and that:

  • I am not barred or disqualified from working with vulnerable groups, children or young people
  • I am not subject to any sanctions or conditions on my employment imposed by the Independent Safeguarding Authority, Secretary of State or other regulatory body.

Signed:…………………………..…………Print Name:………………………Date:………………...

Data Protection:

In accordance with the Data Protection Act 1998, this organisation will only use the information given on this application form to determine your suitable for this post and to monitor equal opportunities. The organisation will keep the application forms of unsuccessful candidate for six months before being confidentiality destroyed.

PART I: REFERENCES

Please provide the names of two professional references, both of whom can write with authority about your performance, abilities and competence in a work, voluntary or educational environment. Please give the name and address of your current or most recent employer in Section 1. If you are not currently working with young people / vulnerable adults but have done so in the past please provide reference details from a past employer for whom you worked in this capacity in Section 2. References will not be accepted from colleagues, relations or people who know you solely as a friend. All offers of employment are subject to Enhanced Disclosure and Barring (DBS) Clearance Checks.

1. Current Employer Reference (or most recent employer) / 2. Second Employer / Professional Reference
Name: / Name:
Job Title: / Job Title:
Company: / Company:
Address: / Address
Tel No: / Tel No:
Email: / Email:

If you would prefer that your referees are not approached until after the interview stage, please tick this box: 

Declaration

  • I declare that to the best of my knowledge and belief, the information given is true and accurate. I accept that providing deliberately false information could result in my dismissal, if appointed.
  • I understand that employment will be considered subject to satisfactory references and an Enhanced DBS Clearance Check, including a Children’s Barred List Check and an Adult’s Barred List Check (for all Regulated Activity appointments).
  • I confirm I am entitled to live and work in the United Kingdom.
  • I am willing for this data to be held and processed by Foxes Academy Ltd and to be verified with relevant third parties. I understand this may include previous employers.

Signature of Applicant ……………………..……………..Date…………………...

Application packs should be returned either by email: or post:

Personnel Department

Foxes Academy

Selbourne Place

Minehead

Somerset

TA24 5TY

Please note application packs received after stated closing date will not be included.

As users of the disability symbol, we guarantee to interview all disabled

applicants who meet the minimum criteria for all vacancies available.