Job Application Form

GUIDANCE NOTES FOR APPLICATIONS

  • The information you supply on the application form and any supplementary material you include is what will be used to compile a shortlist of candidates to invite to attend an interview.
  • Please complete the application form online.
  • Make an entry in every box. If you have nothing to put in the space, please write N/A rather than leave it blank.
  • You may wish to include a CV with your application. Avoid writing “see CV” on the application form, just in case your CV and form become separated.
  • Mark any additional sheets with your name and the position for which you are applying.
  • Please complete the Equality and Diversity form, with your application form. The information you supply will not be used as part of the selection process.
  • Please, supply contact details for at least two references covering a minimum of 12 months. These should be from your and most recent former employer. If you have not held a position of paid employment, you may give details of someone connected with you in any un-paid / voluntary work you have undertaken or any period of study.
  • Please, supply contact details including professional email of all previous care related employment in the last 5 years. In line with regulatory standards, references must be requested by any previous care providers worked at.
  • All employees will come into contact with the people we provide services in the course of their duties so you will be required to undertake an Enhance Disclosure from the DBS.
  • Please, remember to sign and date the application form before returning it.
  • You may wish to keep a copy of your application form so that you may refer to it later, if you are invited to attend an interview.

We are looking forward to receive your application.

    POSITION APPLYING FOR

    How did you hear about this vacancy?

    PERSONAL INFORMATION

    Title

    Full Name *

    Address

    Email *

    Date

    Contact Number

    Curriculum Vitae

    Do you hold a current driving licence?

    Do own a car?

    Do you have any health or wellbeing conditions that merit extra support or that you require to be taken into account?

    If YES, please provide details

    Are you registered with SCW?

    RIGHT TO WORK

    Do you require a work permit or visa to work in the UK?

    If YES, when does this expire?

    WORK AVAILABILITY

    Days and hours available – Tick the days available and state the number of hours willing to do per each day.

    No preference

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Saturday

    Sunday

    EDUCATION AND QUALIFICATIONS

    TRAINING

    Start with most recent and relevant to the post

    CURRENT OR MOST RECENT EMPLOYER

    Company Name

    Address

    Job Title

    Reasons for leaving

    Date commenced

    Date left

    Salary / Hourly rate

    Notice required

    Line Manager Name

    Contact number

    Email

    Describe your main duties and responsibilities

    PREVIOUS EMPLOYMENT HISTORY

    (Please include details of ALL employment since the age of 16. Start from most recent.)

    Job Title

    From

    To

    Company Name

    Company Address

    Main responsibilities

    Reasons for leaving

    Job Title

    From

    To

    Company Name

    Company Address

    Main responsibilities

    Reasons for leaving

    Job Title

    From

    To

    Company Name

    Company Address

    Main responsibilities

    Reasons for leaving

    Job Title

    From

    To

    Company Name

    Company Address

    Main responsibilities

    Reasons for leaving

    Detail any employment gaps (month and year) along with explanation for the gap.

    REFERENCES

    Please provide at least 2 references (a professional and Character details to cover a minimum of 12 months period.

    Professional reference:

    Name

    Job Title

    Name of company

    Address

    Work/Professional Email

    Contact Number

    Permission to contact?

    Character reference:

    Name

    What is your relationship?

    Address

    Email

    Contact Number

    Permission to contact?

    Candidate Consent

    Aligned with new regulations it is required that you provide consent to obtain references before commence employment with Leison Care Services.

    By signing the below you DO consent to us contacting all the above referees to obtain all relevant references required before you commence employment.

    Candidate Consent

    Because of the nature of the work, post within Leison Care Services Ltd are exempt from the provisions of Section 4 (2) of the Act.

    Having a conviction will not necessarily prevent applications from being considered for the post.

    Applicants are therefore not entitled to withhold information about convictions which for “other” purpose are spent under the provisions of the Act. If you are employed by Leison Care Services Ltd, any information given will be completely confidential, any failure to disclose convictions, cautions, reprimands, or final warnings could result in disciplinary action up to and including dismissal.

    All employees will be registered with the DBS and applications cannot be accepted from individuals who are disqualified from working with vulnerable adults/children.

    Have you lived outside the UK for a period of 6 months or more within the last 5 years?

    If YES, you will be required to apply for an overseas police check.

    Have you ever had any convictions or cautions which would not be filtered under DBS guidance?

    If YES, please provide details in a separated signed statement.

    Are there any criminal proceedings pending against you?

    If YES, please provide details in a separated signed statement.

    I hereby declare that the information given in this application is to the best of my knowledge, correct and I understand that any information I have knowingly given which proves to be false could lead to disciplinary action being taken which could lead to my dismissal.

    EQUALITY AND DIVERSITY FORM

    Your answers will be treated confidentially and will not affect your application in any way.

    Title

    Other Title (Please Specify)

    First Name

    Surname

    Age

    Gender

    If you identify as transsexual, transgender (in that you have effected a permanent change of gender identity) or as intersex, which group do you most identify with?

    Gender identity (if appropriate)

    PERSONAL DETAILS

    Ethnic origin: Please click against one of the following -

    Asian or Asian British

    Any other Asian background. Please specify if you wish

    Mixed

    Any other Mixed background. Please specify if you wish

    Black or Black British

    Any other Black background. Please specify if you wish

    White

    Any other White background. Please specify if you wish

    Chinese or Other ethnic group

    Any other Chinese background. Please specify if you wish

    Disability: Please click against one of the following -

    Do you consider yourself to have a disability under the Equality Act 2010?

    If you answered ‘Yes’, please describe the nature of your disability:

    In the Act, a person has a disability if:

    • they have a physical or mental impairment

    • the impairment has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities

    For the purposes of the Act, these words have the following meanings -

    • 'substantial' means more than minor or trivial

    • 'long-term' means that the effect of the impairment has lasted or is likely to last for at least twelve months (there are special rules covering recurring or fluctuating conditions)

    • 'normal day-to-day activities' include everyday things like eating, washing, walking and going shop-ping

    Religion or belief: Please click against one of the following -

    Please specify if you wish

    Sexual orientation: Please click against one of the following -

    Please indicate the print or online source where you saw this position advertised: