Position applied for: Full time Residential Support Worker Part-time Residential Support Workerond Choice Casual Residential Support Worker Deputy Manager Registered Home Manager Teacher Teaching assistant Any Former Names? Email Address Postcode Mobile Telephone Number Home Telephone Number Date Of Birth (Day) Date Of Birth (Month) Date Of Birth (Year) National Insurance Number: Do you hold a full, clean driving licence, valid in the UK? Yes for Manual & Automatic Yes for Automatic No I have a Provisional Licence Are you free to remain and take up employment in the UK?
You will be required to provide appropriate documentary evidence of this at interview. For examples of acceptable documents please see www.ukba.homeoffice.gov.uk
CONVICTIONS/DISQUALIFICATIONS: Have you ever been disqualified from working with children? Yes No Convictions/Disqualifications: Has your conduct in relation to children ever been a cause for concern or investigation? Yes No If yes, to either of the above questions, please provide details:
Upon offer of employment we reserve the right to request a Criminal Records Bureau Disclosure at Enhanced level and this disclosure will include details of cautions, reprimands or final warnings as well as convictions.
Care Afloat is obliged, under arrangements introduced for the protection of children and vulnerable adults, to check with the Disclosure and Barring Service (DBS) for the existence and content of any criminal record prior to appointment to such posts, which involve direct contact with young people.
For these posts, the preferred candidate will be required to declare any pending prosecutions, convictions, cautions or bind-over’s they may have, even if they would otherwise be regarded as ‘spent’ under the Rehabilitation of Offenders Act 1974. You are strongly advised to also declare any charges that may have been made against you or not and whether a court appearance was made or not and any involvement in any Child Protection Procedures. Failure to do so may lead to doubts being raised about your openness and honesty and could affect your application.
Please provide details of any convictions or cautions under the terms of the Rehabilitation of Offenders Act 1974: Are you related to, have a close personal relationship or know any Care Afloat employee? N.B. This includes friends and non-blood relatives If the answer to the above question is yes, please state their name and position held and describe the relationship. Disciplinary Action at Work: Have you ever been subject to Disciplinary Action, a Formal Warning, suspension and/or dismissal from a place of employment? If yes, please give details: Disciplinary Action at Work: Have you ever been subject to Disciplinary Proceedings including disqualification for caring for Children under the Disqualification Caring for Children Regulations 1991? If yes, please give details including dates: Are you on the update service
The Update Service is an online subscription service that lets you keep your standard and enhanced DBS certificates up-to-date. It also allows employers to check a certificate online, with your consent.
Working with Children and Young People includes shift work, unsociable hours and Sleep-ins. Are you prepared to work these? This post requires staff to complete and attend mandatory training sessions at various intervals throughout the year regardless of position held – are you prepared to commit to attending these sessions? EDUCATION: School (11+) Education: Date From: Education: Date To: EDUCATION: Qualifications and grades Education: Further Education (16+) Education: Date From: Education: Date To: EDUCATION: Qualifications and grades Other Qualifications & Training
Please list any other relevant qualifications or training you have (you will be asked for evidence of these at interview)
Address: Position held: Reason for leaving: Reason for leaving: Reason for leaving: Reason for leaving: Please list any other previous employment with dates. Please type 'none' if this is not applicable.
It is important that you account for the time from leaving full time education to the present with no gaps.
Please use this space to explain any gaps in employment. Please type 'none' if this is not applicable.
For example- unemployment/stay at home parent etc…
Have you ever worked or lived outside of the UK? If yes, please provide details, including dates
Please note if you are successful we will have to obtain a certificate of good conduct from the country that you worked/ lived in. Further details can be found at: https://www.gov.uk/government/publications/criminal-records-checks-for-overseas-applicants
Supporting statement and achievements
Please use this space to tell us how you meet each of the points on the person specification. We need to have this information in order to consider your application.
REFERENCE 1 (Current /Last employer) Name:
Your first reference MUST be your present employer – if you are currently not in employment the reference MUST be supplied by your last previous employer. PLEASE NOTE: Care Afloat will not accept references from relatives.
Organisation name & address Email Contact Number REFERENCE 2 (previous employer) Name:
Ideally a 2nd reference should be a previous employer or tutor. If you have not had previous employment we will accept a character reference.
Organisation name & address Email Contact Number REFERENCE 3 (Character reference) Name:
We cannot accept references from relatives.
Name & address Email Contact Number DECLARATION- I agree that Care Afloat can create and maintain computer and paper records of my personal data and that this will be processed and stored in accordance with the General Data Protection Regulations 2018. Unsuccessful applications will be disposed of securely after a period of 12 months. I confirm that all the information given by me on this form is correct and accurate and I understand that if any of the information I have provided is later found to be false or misleading, any offer of employment may be withdrawn or employment terminated. Name