REFERENCES: You must provide references from your two most recent employers. Please provide an additional character reference. Please inform the referees your intention to use their name. If you are unable to provide three references, please speak to us. The offer of employment is subject to the receipt of TWO satisfactory references. ADDITIONAL INFORMATION: In this section, you can tell us more about why you want to work within our organisation including what personal qualities, strengths and expertise you can bring to the job. OTHER EMPLOYMENT: Please tell us about any other employment you would continue with if we offered you within our organisation.

In this section you can tell us about why you want to work within our organisation including what personal qualities, strengths and expertise you can bring to the job:

Your GP will not be contacted without your permission, your Next of Kin, emergencies only

I confirm that the information I have provided in this application form is correct and accurate to the best of my knowledge.

1. Proof of identity including a recent photograph.
2. Where required for the purposes of an exempted question in accordance with section 113A(2)(b) of the Police Act 1997(1), a copy of a criminal record certificate issued under section 113A of that Act together with, after the appointed day and where applicable, the information mentioned in section 30A(3) of the Safeguarding Vulnerable Groups Act 2006 (provision of barring information on request)(2).
3. Where required for the purposes of an exempted question asked for a prescribed purpose under section 113B(2)(b) of the Police Act 1997, a copy of an enhanced criminal record certificate issued under section 113B of that Act together with, where applicable, suitability information relating to children or vulnerable adults.
4. Satisfactory evidence of conduct in previous employment concerned with the provision of services relating to— (a) health or social care, or (b) children or vulnerable adults.
5. Where a person (P) has been previously employed in a position whose duties involved work with children or vulnerable adults, satisfactory verification, so far as reasonably practicable, of the reason why P’s employment in that position ended.
6. In so far as it is reasonably practicable to obtain, satisfactory documentary evidence of any qualification relevant to the duties for which the person is employed or appointed to perform.
7. A full employment history, together with a satisfactory written explanation of any gaps in employment.
8. Satisfactory information about any physical or mental health conditions which are relevant to the person’s capability, after reasonable adjustments are made, to properly perform tasks which are intrinsic to their employment or appointment for the purposes of the regulated activity.
9. For the purposes of this Schedule— (a)“the appointed day” means the day on which section 30A of the Safeguarding Vulnerable Groups Act 2006 comes into force; (b)“satisfactory” means satisfactory in the opinion of the Commission; (c)“suitability information relating to children or vulnerable adults” means the information specified in sections 113BA and 113BB respectively of the Police Act 1997.

Disclosure Form
Criminal Record Preliminary Disclosure:
Workers of the Home are subject to Police Record Check through the DBS. Please declare all criminal convictions, whether
spent or not, charges, whether proceeded with or not and warnings and cautions.

I declare that to the best of my knowledge and belief, the information given by me in this application is true and I understand that the above information forms the basis of my contract of employment. I understand that if any of the information supplied by me is found to be falsely declared, my contract may have been fundamentally breached and my employment terminated immediately. I understand that I cannot be offered a post until a satisfactory response has been received with respect to my DBS Register status and should I consequently be offered a post, that offer will be subject to two satisfactory references, one of whom should be from my previous employer and that confirmation of the employment will be subject to a satisfactory criminal check from the DBS. I understand that until this information has been returned, I will be unable to work for the organisation. I undertake to inform my employer immediately if my DBS register status or criminal status changes at any time during my employment, such as being charged with an offence (other than motoring offences). The administering of a warning, criminal conviction, referral to any register of barred care workers or withdrawal of any registration required by my employment status.