Supporting statement

Please ensure you read all sections of the Role Profile before completing this form.

Please submit the completed form along with your CV and the completed

Equality and Diversity Monitoring Form.

Job details

Position applied for:
Location: (if applicable)
How did you find out about this vacancy?

Personal details

Title (Mr/Mrs/Miss/Ms/Other):
Family Name:
First Names (s):
Name you prefer to be known as:
Any other names by which you have been known:

Contact details

Home address:
Postcode:
Personal email address:
Telephone number:

Experience of homelessness

Evolve Housing + Support encourages applications from all sections of the community, specifically those with lived experience of homelessness. Answering this question will help us to monitor and improve our performance in this area.

Have you experienced being homeless, and/or of using homelessness (or similar) services?

Yes No

Disability

In order to consider any adjustments, please state whether you have a disability which may affect your application or employment.
Yes No
If yes, please give details:

Supporting Statement for Application

Please give a brief outline of how you meet the requirements of the Person Specification.
Please ensure that you address each of the points set out under the column ‘Assessed via Application’, and give examples where possible.

References

We require a minimum of 2 references covering the past 5 years. One MUST be a manager or HR contact at your current or most recent employer. No references will be obtained without your prior consent.

Current/Most Recent Employer Reference

Reference covers dates from: / to:
Name of organisation:
Name of manager or HR contact :
Job title of manager or HR contact:
Manager or HR contact address:
Manager or HR contact work email:
Manager or HR contact telephone number / :
Any additional relevant information:

Previous employer reference

Reference covers dates from: / to:
Name of organisation:
Name of manager or HR contact :
Job title of manager or HR contact:
Manager or HR contact address:
Manager or HR contact work email:
Manager or HR contact telephone number / :
Any additional relevant information:

Additional References

Please give any additional references which cover the past 5 years (if your employment history does not go back 5 years you may include education/voluntary work references).

(Please see next page)

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Dates reference
covers / Name of organisation / Name of contact / Contact’s relationship to you / Contact’s professional email address

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Additional Information Required

Please complete the following sections and sign the declaration at the end of this application.

Right to Work in the UK

I confirm that I have the right to work in the UK and that I will produce documents to confirm this if I am selected for interview.

(Please tick as appropriate)

Yes No

Enhanced DBS Disclosure

This post is subject to an enhanced Disclosure and Barring Service (DBS) check. If your application is successful, a DBS check will be made.

If you have a current DBS certificate, (issued in the past 12 months), please tick this box

Declaration of Criminal Record

Evolve Housing + Support is committed to recruiting employees from all sections of the community, including offenders and ex-offenders.

Due to the nature of the customer group with which we work, Evolve Housing + Support may be exempt from the restrictions in place under the Rehabilitation of Offenders Act 1974 and therefore you may be required to disclose any convictions, including those that are ‘spent’ under the terms of the Act.

Any information provided is treated in the strictest confidence and will only be taken into account where, in the reasonable opinion of Evolve Housing + Support management, the offence is relevant to the post for which you are applying.

Please note that failure to disclose a conviction may result in any offer of employment being retracted, or employment terminated if an offence is discovered during employment.

Do you have any criminal convictions, either unspent or spent, as covered by the Exception Order 1995? (Please tick as appropriate) Yes No

If you have answered ‘yes’, you will be required to provide details of your conviction/s if you are selected for interview.

Declaration
I declare that the information I have given on this form is correct and complete. I understand that false or misleading statements may be sufficient grounds for cancelling any agreements made. This application is submitted on the basis that I consent to the processing of all data I have provided, including sensitive personal data.
Signed:
Dated:

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