Employee Application Form

Please read all instructions, job description and person specification prior to completing this form.

Post Applied For:

Preferred Region:

Where/how did you hear about the vacancy? If you were referred please state who.

Preferred Employment:

Personal Details

Title:

First Name(s):

Surname:

Address:

Home Telephone Number:

Mobile Telephone Number:

Email:

Work Telephone Number:

Are you entitled to work in the UK?

Do you need a Visa to work in the UK? (Provide details):

Are you registered with the SSSC?:

If yes, please provide your SSSC Registration number:

Are you a member of the PVG Scheme?

If yes, please provide PVG number:

Do any of your family members currently work for Care Visions?

Do you hold a current full driving licence?
(Please note for the post of Residential Child Care Worker a manual driving licence is a requirement):

Type of licence held:

Does your licence have penalty points or endorsements?

If yes, please give details:

Education

Name of School Attended:

Date Attended:

Qualifications Gained At School (Subject, Grade):

Have you completed further education? YesNo

If yes, please provide details below:
(Name College/University, Any courses for which a certificate, e.g. SVQ, HNC, HND, degree or diploma was awarded. Name of Institute/College Qualification Subject Date Gained)

Membership of Professional Bodies

Are you currently a Membership of any Professional Bodies? YesNo

If yes, please provide details below:
(Name of Awarding Body/Institution, Class of Membership, Date of Re-registration)

IT Skills

Please indicate your level of competency with the following packages:

Word -

NoneBasicIntermediateAdvanced

Excel -

NoneBasicIntermediateAdvanced

Outlook -

NoneBasicIntermediateAdvanced

PowerPoint -

NoneBasicIntermediateAdvanced

Other -

NoneBasicIntermediateAdvanced

Records Check

Are you currently or have you previously been subject to investigation or disciplinary proceedings? YesNo

If yes, please give details:

Have you been convicted of any criminal offences (including driving offences) which are currently not spent under the Rehabilitation of Offenders Act? YesNo

If yes, please give details:

Are you presently the subject of a criminal investigation? YesNo

If yes, please give details:

The disclosure of a criminal record will not debar you from appointment unless the selection panel considers that the conviction renders you unsuitable for appointment. The Rehabilitation of Offenders Act 1974 (Exclusions and Exceptions) (Scotland) Amendment Order 2015 requires you to self-declare any unspent convictions or any convictions that are listed in the “offences which must always be disclosed list” Please refer to:
www.disclosurescotland.co.uk

Failure to disclose convictions that are not considered spent or are included in the offenses which must always be disclosed list may disqualify you from appointment or lead to summary dismissal.

If selected for the position, we will check your details against criminal records held by the Police, prior to an offer of employment and if you have spent convictions that have not been removed by a Sherriff that are included on the “offences which are to be disclosed subject to rules list” you will be asked to declare them at a later stage. Please refer to: www.disclosurescotland.co.uk

Additional information relating to The Rehabilitation of Offenders Act 1974 (Exclusions and Exceptions) (Scotland) Amendment Order 2015 can be found by clicking on the following link: www.legislation.gov.uk

Employment

Please provide details of your past employment history to date, starting with your most recent. All dates from leaving school must be detailed accounting for any periods of time not spent in further education or employment. Please note that references may be sought from any of your previous employers

Present or Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Nature of Business:

Reasons For Leaving:

Main Duties & Responsibilities:

Referee
References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.

Name:

Job Title:

Relationship to You:

Email:

Phone Number:

May we contact this person now?

YesNo

If no, please detail why:

Next Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Nature of Business:

Reasons For Leaving:

Main Duties & Responsibilities:

Referee
References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.

Name:

Job Title:

Relationship to You:

Email:

Phone Number:

May we contact this person now?

YesNo

If no, please detail why:

Next Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Nature of Business:

Reasons For Leaving:

Main Duties & Responsibilities:

Referee
References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.

Name:

Job Title:

Relationship to You:

Email:

Phone Number:

May we contact this person now?

YesNo

If no, please detail why:

Next Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Nature of Business:

Reasons For Leaving:

Main Duties & Responsibilities:

Referee
References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.

Name:

Job Title:

Relationship to You:

Email:

Phone Number:

May we contact this person now?

YesNo

If no, please detail why:

Next Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Nature of Business:

Reasons For Leaving:

Main Duties & Responsibilities:

Referee
References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.

Name:

Job Title:

Relationship to You:

Email:

Phone Number:

May we contact this person now?

YesNo

If no, please detail why:

Mandatory Additional Information

1. Please provide details of any relevant skills you will bring to the post. This can include training, qualities, achievements at work and non-work related or voluntary experience. Please refer to the skills outlined in the person specification supplied.

2. Please give reasons for applying for this post. We are particularly interested in your reflections on your own personal history and the experiences which have shaped you.

Declaration IMPORTANT(Please read carefully before submitting)

Data Protection

In accordance with the Data Protection Act of 1988, the information entered onto this form and any accompanying papers will be used to assess your suitability for the post and will not be released to anyone who does not require it for this purpose. If you are employed the information you have provided on this form will be used for personnel record and payroll purposes, otherwise the information will be destroyed six months after the post has been filled.

You have the right to require us to correct any inaccuracies in your information.

I certify that to the best of my knowledge all statements given by me on this form are true and accurate. I understand and accept that if it is subsequently discovered that any statement is false or misleading or that I have withheld information, my employment may be terminated without notice.