NI Number:

APPLICATION FORM CONFIDENTIAL

National Insurance Number / Enter your National Insurance Number here. /

SectionAisonlyusedfor gatheringinformationandcontactdetails.Itwill be detachedfromyour applicationform for shortlistingpurposesto ensureobjectivity withintherecruitmentprocess.

SectionA

PostAppliedFor / Click here to enter text. /
PostReferenceNumber / Click here to reference number. /
Where did you see this vacancy advertised? / Click here to enter text. /

Personal Details

Title / Choose your title. /
FirstName(s) / Click here to enter your first name(s). /
Surname / Click here to enter your surname. /
Previous surname(s) / Click here to enter any previous surnames. /
Address / Click here to enter your address. /
Post Code / Click here to enter your post code. /
HomeTelephoneNumber / Click here to enter yourhome phone number. /
MobileNumber / Click here to enter yourmobile phone number. /
Email Address / Click here to enter your email address. /

Additional Information

Doyou have anyunspentor pendingconvictions undertheRehabilitation ofOffenders Act1974? / Choose an item. /

Rehabilitation of OffendersAct 1974(Exceptions) Order1975 and PoliceAct 1997

Ifthejob advertisement has indicated that the post for whichyou are applying is to be subjectto aDBSDisclosure,thenyou arerequired toreveal any criminal convictions, bind-over orders or cautions,including thosewhichwould normally beregarded as spent.

Doyou have anyconvictions,bind-over orders or cautions? / Choose an item. /

If YES,pleaseprovidedetails,including dates,onaseparate sheetalong with your application form,marked “Strictly Privateand Confidential”. PleaseensureyourNI Numberisplaced onany additional correspondence.

Acriminal recordwill notnecessarilybar youfromworkingfor NPTHomes.This will dependon thenatureofthejobyou areapplyingfor andthecircumstances andbackground ofyour offences.

Employment Restriction/Regulations

Pleasecircleyour response and give details,if appropriate.

Tothebestofyour knowledge, areyourelatedtoanycurrentor former: member ofstaff,Boardmember or contractor/consultant of NPTHomes? / Choose an item. /
IfYES,please give details i.e. theirname and howthey arerelated to you:
Click here to enter details of your relative(s). /
Haveyou been employed byNPTHomes withinthelast12months? / Choose an item. /
IfYES, pleasegive details:
Click here to enter details of your previous employment with NPT Homes. /
In accordancewiththeAsylumandImmigration Act1996,areyou entitledtowork intheUK? / Choose an item. /
IfNO, please give details (or give details ofwhenanycurrentwork permit/visais duetoexpire):
Click here to enter details of your entitlement to work. /
Doyou holdafull currentdrivinglicencevalidfor useintheUK? / Choose an item. /
Ifyou holdanon-UKlicence,pleasegivethecountryofissue: / Click here to enter country name. /
Doyou holdbusinessuse carinsurance? / Choose an item. /
Doyoucurrentlyhave anyemploymentotherthanyour mainjob? / Choose an item.
IfYES, pleaseprovidedetails:
Click here to enter details of your other employment. /
Doyouwishto applyfor this postonthebasis ofan alternative workingpattern?
E.g. Jobshare,Reduced/compressedhours,Term Timeworking. / Choose an item.

Referees

Pleasesupply thenames,addresses,telephonenumbers ande-mailaddresses oftwo referees,oneofwhichmust beyourpresentor mostrecent employer.

Ifyouhavenotpreviously worked, pleasegivethename ofaresponsiblepersonwhoknows youwell.

Refereesshould notberelated to you.

References maybetakenup prior toanyofferofemployment.Thereforeifyou donotwish us tocontactyour referees,pleasecheck the box:☐

1. Presentor mostrecentemployer
Name / Click here to enter reference’s name. /
Address / Click here to enter reference’s address. /
Telephone Number / Click here to enter reference’s phone number. /
Email / Click here to enter reference’s email. /
Relationship / Click here to enter your professional relationship to the reference. /
2. Other
Name / Click here to enter reference’s name. /
Address / Click here to enter reference’s address. /
Telephone Number / Click here to enter reference’s phone number. /
Email / Click here to enter reference’s email. /
Relationship / Click here to enter your professional relationship to the reference. /

Equal Opportunities Monitoring Form

CONFIDENTIAL

NPTHomesis workingtowards promoting and ensuringequalityofopportunityinemployment andservice delivery.Itis our policytoensurethatall applicationsforpostsareconsideredon thebasis ofmerit,andnotduetoa protectedcharacteristic listedunder the EqualityAct2010.Toensurethis policyis carriedouteffectively,all applicantsare askedtoprovidetheinformation requestedonthisform.Itwill be usedonlyforadministrative and monitoringpurposes andwillbeconfidentialandnotusedtodiscriminateinfavouror againstanyindividual applicant.

Date of Birth / Click here to enter your date of birth. /

Gender

Whatis your gender? / Choose an item.
Doyouidentifyas transsexual? / Choose an item.
Doyouidentifyas transgender? / Choose an item.

Marital Status

What is your marital status? / Choose an item.

Sexual Orientation

What is your sexual orientation? / Choose an item.

Religion, Faith, Belief

What is your religion, faith or belief? / Choose an item.

Nationality

What is your nationality? / Choose an item.

Ethnic Origin

What is your ethnic origin? / Choose an item.

Welsh Language

How fluent are you at Welsh? / Choose an item.

Disability

NPT Homes actively encourages applications from people with disabilities.

The Equality Act 2010 defines a person with disability as someone who has “physical or mental impairment which has a substantial and long-term adverse effect on his/her ability to carry out normal day to day activities”.

If you need clarification on the day to day requirements for this job, please contact the HR Section on 01639 505852/53.

Doyouconsider yourselftohaveadisability? / Choose an item.
If‘YES’, please explainthetypeof disabilityyouhave:
Click here to enter details of your disability. /

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