Application for Employment

Please refer to the Guidance Notes enclosed before completing this form. You should use BLACK pen or type your responses. Please return the form as shown on the last page.

FOR OFFICE USE ONLY      Date application received:      

Applicant number:      

Application for the post of:       Location:       Reference:       Closing date:

Tick one or both boxes: I am ideally looking for a Full time ☐ Part time ☐ position

First Name:       Last Name:      

Preferred Name:      Preferred Title Mr/Miss/Ms/Mrs/Other*      

If Other please specify

Home Address:       County:      

Postcode:      

Daytime telephone number:       May we contact you there? ☐ Yes ☐ NoEvening telephone number:       May we contact you there? ☐ Yes ☐ NoMobile telephone number:       Email address:      

Notice Period:

Current/most recent employment

Current/Previous Employer’s Name:      

Address and type of business:       Job Title:      

From:       To:      

Salary/Hourly Rate:      

Other Benefits:      

Reason for leaving/wishing to leave:      

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Brief description of main duties:      

Previous employment & work experience (please list all other previous employers/voluntary experience from leaving school, most recent employer first)

Previous Employer’s Name and Address

Position Held From To Brief description and Reason for Leaving

                             

Education

Secondary School/College/University From To Qualifications (GCSEs: A levels: NVQs: Degree etc)

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Training

Courses Title and Subjects Covered Date and Duration Training Organisation                 

Knowledge, experience and skills

Use this section to demonstrate how your skills, knowledge and experience match up to the job requirements on the person specification. Please provide evidence to demonstrate how you meet criteria on the person specification. Use the margin to insert the criteria number so that the short listing manager can clearly identify which criteria you are evidencing. Please use a maximum of 3 sides only.Criteria Number:      

Qualifications/Knowledge           

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Experience           

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Knowledge, Skills and Abilities           

Personal/Equal Opportunities

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Professional Qualifications/Membership

Are you a member of a professional organisation? ☐ Yes ☐ No

What is your membership level?      

Name of Professional Organisation      

Driving Licence

Do you hold a current, valid driving licence? ☐ Yes ☐ No

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Do you own or have use of a car? ☐ Yes ☐ No

Immigration, asylum and nationality act (2006)

Under Immigration, Asylum and Nationality Act (2006) we are required to check that members of staff are legally entitled to work in this country. If you are successful in your application we will ask you for more information, but in the meantime please let us know your national insurance number.

National insurance number:            

     

     

     

     

     

           

Are you entitled to work in the UK? ☐ Yes ☐ No

Working Time Regulations

Under the Working Time Regulations we are required to make sure that members of staff are not working more than 48 hours per week. Do you plan to continue to work for another employer if you are successful with this application?     

Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 2010 & the Safeguarding Vulnerable Groups Act 2006

We are unable to consider your application unless you complete the relevant questions on the form attached.

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References

Please give the names and addresses of two people who can provide an assessment of your suitability for this post. If references do not cover the last 3 years, please provide details of further referees on a separate sheet. If you are employed or have been employed, please give your current or most recent employer. Relatives and friends should not be used as referees.Name:      

Address:      

Telephone Number:      

Email:      

Relationship:      

Name:      

Address:      

Telephone Number:      

Email:      

Relationship:      May we approach this person without further reference to you?

☐ Yes ☐ No

May we approach this person without further reference to you?

☐ Yes ☐ No

Declaration

I declare that to my knowledge, the information on this application and submitted on any accompanying documents is full and correct. I understand that if I have given false or misleading information or withheld any information in this application, SHS may unilaterally withdraw any offer made to me or dismiss me if I am appointed.

I consent to SHS undertaking any checks it may deem necessary in connection with my application and I agree to SHS asking my previous employers questions regarding my employment record and give my consent for my previous employers to disclose this information.

In accordance with the Data Protection Act 1998 as part of this application you give SHS permission to collect, retain and process information about you. The information you provide in this application form, recruitment monitoring form and rehabilitation of offenders form will only be used for the purpose of assessing your suitability for employment, for monitoring the our compliance with the law and best practice in terms of equal opportunity and non-discrimination and SHS policies and procedures and human resource management purposes. If your application is unsuccessful it will be kept for 6 months and then confidentially destroyed.

Signed:      Date:      

We appreciate the time you have taken to provide us with this information. Thank you.

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If you send this form via email you will be asked to sign a copy if you are successful in gaining an interview.

Please return your competed Application Form, Recruitment Monitoring and the Rehabilitation of Offenders Act/Safeguarding Vulnerable Groups Act forms to: recruitment@shs.org.uk

OR by post to:

SHS, Human Resources, Third Floor, Solar House

1 – 9 Romford RoadStratfordLondonE15 4LJ

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Recruitment Monitoring Form

SHS is committed to the principle of Equality of Opportunity in its employment policies and practices. The information you provide will be treated as confidential and be used for no purpose other than for monitoring.

In accordance with the Codes of Practice of the Commission for Racial Equality and the Equal Opportunities Commission, SHS monitors its selection decisions to assess whether or not such policies are effective. In order to carry out this process we ask you to provide the following information. This information will be detached from your application, stored separately and only be used for statistical purposes, to ensure that SHS’s recruitment process is free from bias. It will not be used in assessing your suitability for employment.

You are not obliged to answer the questions but your co-operation in completing this form would be greatly appreciated. On completion this form should be returned with your application form.

Position applied for:       Ref:      

Gender: (please tick) Male ☐ Female ☐

Date of Birth:      

Age range (please tick): 16-25 ☐ 26-35 ☐ 36-45 ☐

46-55 ☐ 56 and over ☐

How did you obtain information about this vacancy (please tick)?

Word of mouth ☐ SHS Website ☐ Speculative approach ☐

Advertisement ☐ (Please state which paper)      

We appreciate that some people may find the question on sexual orientation to be an extremely personal one and we must therefore advise you are under no obligation to answer it.The groups listed below are in line with best practice based on Stonewall research.

 I would describe my sexual orientation as (please tick): Bisexual ☐ Gay man ☐ Gay woman/Lesbian ☐ Heterosexual/Straight ☐ Other ☐ Prefer not to say ☐

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Self-classification form Please ✓ the appropriate boxes below that apply to you.Ethnic OriginEthnic Group refers to a ‘racial group’ defined by the Race Relations Act 1976 as a group of persons described by reference to colour, race, nationality or ethnic or national original. The groups listed are in line with Commission for Racial Equality recommendations. UK citizens can belong to any of the groups indicated.

I would describe my ethnic origin as (please tick):

a. White1. BRITISH2. IRISH3. ANY OTHER WHITE BACKGROUND (please specify) ______________________________

c. Asian or Asian British1. INDIAN2. PAKISTANI3. BANGLADESHI4. OTHER ASIAN BACKGROUND (please specify)______________________________

e. Chinese/Other1. CHINESE2. ANY OTHER BACKGROUND (please specify)______________________________

☐☐☐

☐☐☐☐

☐☐

b. Mixed1. WHITE AND BLACK CARIBBEAN2. WHITE AND BLACK AFRICAN3. WHITE AND ASIAN4. OTHER MIXED BACKGROUND (please specify)

______________________________

d. Caribbean, African and any other black background1. BLACK AFRICAN2. BLACK CARIBBEAN3. OTHER BLACK BACKGROUND (please specify)______________________________

f. Religion (optional)What is your religion?1. NONE2. CHRISTIAN3. BUDDHIST4. HINDU5. JEWISH6. MUSLIM7. SIKH8. ANY OTHER RELIGION (please specify)______________________________

☐☐☐☐

☐☐☐

☐☐☐☐☐☐☐☐

Disability

SHS is a disability symbol user with the Job Centre Plus and has signed up to the five key commitments. We will ensure that any applicants who state that they have a disability and who meet the essential criteria for the post will be short listed for an interview. In order to facilitate this, please answer the questions a. and b. (if applicable) below.

*The Equality Act 2010 defines disability as “a physical or mental impairment that has a substantial and long term, adverse effect on a person’s ability to carry out normal day to day activities”

a. Do you consider yourself to have a disability as defined by the Equality Act 2010 1995*? YES ☐ NO ☐

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b. If we invite you to an interview, please state any access, facilitation needs or requirements.

Strictly Private and Confidential

The Rehabilitation of Offenders Act 1974 states than an individual who has had a conviction for an offence may, with certain exceptions, be rehabilitated and allowed to treat the conviction as if it had never occurred. A conviction will become ‘spent’ where the individual has not, after the given period of time laid down in the Act, committed another serious offence. The Act also makes it unlawful for an employer to discriminate in any way against an employee because of a spent conviction.

However, the Rehabilitation of Offenders Act (Exemptions Order) 1975 provides that in certain circumstances the Act shall not apply. This is the case in SHS where due to the nature of the work and services provided, members of staff may have access to, and information about, children and young people.

Applicants are therefore not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of this Act or convictions which are current. For this reason we will seek an enhanced Criminal Records Bureau Disclosure for anyone employed by SHS.

SHS must ensure the welfare and well-being of those to whom we are providing a service, by assessing any potential risk in employing an applicant with a criminal record.

SHS however is committed to providing equality of opportunity in employment and aims to treat applicants with a criminal record in a fair and responsible manner, based on a full assessment of the risks involved. SHS will judge applicants with a criminal record on their ability to do the job and give them equal opportunity alongside other applicants, provided that their record is not related to the job on offer and would not pose any risk to themselves, existing staff members, our clients or reputation.

Last Name:      First Name:      

Date:      

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Completion of the following is required before we are able to consider your application. The Recruiting Manager will not see this form and the information will not be used in deciding whether or not to invite you to attend for interview. This sheet will be separated from your application and held confidentially by Human Resources.

If your application is unsuccessful this information, together with your Application Form and the Equal Opportunities Monitoring Form will be retained for 6 months and then confidentially destroyed.

Have you been convicted of any criminal offence or received a caution, final warning or reprimand (including those regarded as “spent”)?

☐ Yes ☐ No

Are you currently undergoing criminal investigation or have a court case pending?      ☐ Yes ☐ No

If yes, please list below any criminal offences, cautions, final warnings and reprimands whether spent or not, including the dates or any current criminal investigation or court case pending.

(Please note: Giving us this information does not automatically preclude you from being offered a position.)

     

Are you barred by the Independent Safeguarding Authority (ISA) from working or volunteering in a regulated activity?

☐ Yes ☐ No

Do you have a current Criminal Records Bureau (CRB) disclosure? ☐ Yes ☐ No

Please sign below to indicate that you understand that;

a. we will seek an enhanced Criminal Records Bureau Disclosure for anyone employed by SHSb. we are unable to consider any application where this form has not been completed fully.

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Signed:      Date:      

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