Unit 2B01, Southbank Technopark, 90 London Road. London SE1 6LN

Unit 2B01, Southbank Technopark, 90 London Road. London SE1 6LN.

Office number: 020 7928 4267 / 020 7021 0973

Website: email:

Coach Application Form (self-employed)

Personal Details
Full Name: / Title:
Address:
Post Code:
Contact number (home): / Mobile:
Email:
Nationality:
National Insurance No:
Are you a British subject or a national of any EU country?
Do you require a permit to work in the UK?
If not, do you have the right to work in the UK and a current work permit?
Do you hold a current driving license?
Do you have a disability that may affect your application or coaching?
If Yes, please give details:
Qualifications
Please list any qualifications you hold. Include any relevant coaching or teaching qualifications or courses that you have taken. Please include any Child Protection and First Aid Qualifications in this section.
Please note that if successful we will require a copy of all relevant qualifications.
Qualification / Level / Date achieved/ expected

(please continue on separate sheet if necessary)

Current/Previous employment
Please start with your most recent/ current post.
Dates (month/year)
From To / Post / Employer / Details of duties and responsibilities / Reason for leaving

(Please continue on a separate sheet if necessary)

Please give details of any relevant skills/experience gained through employment or voluntary service e.g. voluntary coaching
Supporting Information
Please detail how you meet the requirements for this role, providing examples from your work, voluntary or life experiences, and state why you are applying for this job.

(Please continue on separate sheet if necessary)

References
Please give the name and address of two referees, one of whom should be your current or most recent employer, who can comment on your suitability for this post. If you were known by a different name, please also state this. No reference will be sought without your consent.
Referee 1. / Referee 2.
Name:
Position held:
Address:
Post Code:
Telephone number:
Email: / Name:
Position held:
Address:
Post Code:
Telephone number:
Email:
Weekly Availability
Please indicate your weekly availability by marking the times and days you are able to work with an ‘X’.
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
AM
PM
Criminal Offences
Have you ever been convicted of a criminal offence? Yes No
If yes please give details below of any unspent convictions. As this post is one covered by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 both spent and unspent convictions must be declared [although protected cautions and protected convictions do not need to be declared].
Pre-employment checks
As DSC works with vulnerable children and adults, all coaches are required to apply for a disclosure from the Disclosure and Barring Services (DBS). This was previously known as the CRB check and is an impartial and confidential document that details an individual’s criminal record, and where appropriate, details of those who are banned from working with children. The offer of employment will be conditional on the disclosure proving satisfactory.
Verification of your coaching and/or professional qualifications.
Satisfactory documentary evidence of your eligibility to work in the UK in accordance with current legislative requirements.
The receipt of two references. One referee must be your current or most recent employer.
Declaration
I declare that the information I have given on this form is correct and complete. False or misleading statements may be sufficient grounds for cancelling any agreements made.
Signed:
Date:

Please fill in this application form and post it back to:

Lauren Templeton

Disability Sports Coach Ltd

Unit 2B01, Southbank Technopark

90 London Road

London

SE1 6LN

Or email it to

Disability Sports Coach - Registered in England. Charity Number: 1150294