Application Form

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Position applied for:

Name

First

Last

Any Former Names?

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?

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?

Convictions/Disqualifications: Has your conduct in relation to children ever been a cause for concern or investigation?

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)

EMPLOYMENT HISTORY: Name of current or most recent employer:

Please include any previous experience (paid or unpaid), starting with the most recent first. It is important that you account for the time from leaving full time education to the present.

Address:

Position held:

Date From:

Date employment began

Date to:

Date employment ended (leave blank if still employed)

Reason for leaving:

Notice period:

Please let us know how much notice you will have to give on leaving this post.

EMPLOYMENT HISTORY: Previous employment 1. Name and address of Employer:

Please include any previous experience (paid or unpaid), starting with the most recent first. It is important that you account for the time from leaving full time education to the present.

Date From:

Date employment began

Date to:

Date employment ended

Reason for leaving:

EMPLOYMENT HISTORY: Previous employment 2. Name and address of Employer:

Please include any previous experience (paid or unpaid), starting with the most recent first. It is important that you account for the time from leaving full time education to the present.

Date From:

Date employment began

Date to:

Date employment ended

Reason for leaving:

EMPLOYMENT HISTORY: Previous employment 3. Name and address of Employer:

Please include any previous experience (paid or unpaid), starting with the most recent first. It is important that you account for the time from leaving full time education to the present.

Date From:

Date employment began

Date to:

Date employment ended

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. Person specifications can be found on our News and Events page under Careers.

REFERENCE 1 (Current /Last employer) Name:

First

Last

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

Contact Number

REFERENCE 2 (previous employer) Name:

First

Last

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

Contact Number

REFERENCE 3 (Character reference) Name:

First

Last

We cannot accept references from relatives.

Name & address

Contact Number

AVAILABILITY

Please use this space to record dates of any holidays that you have pre-booked.

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

First

Last

If you were referred to this post by an existing employee, please supply their name:

Care Afloat operates a refer-a-friend scheme.