Application Form

    Post Details

    Personal Details

    Under The Assignment and Immigration Act 1996,

    Employment Details

    Current Or Last Post:

    Past Employment


    Education And Training

    Please Give Details Of Schools, Further Education and Professional Training


    Other Relevant Training Undertaken

    Organising Body



    I declare that to the best of my knowledge that information that I have given on this form is true and accurate. I understand that if I knowingly withhold information or include information I may be liable to instant dismissal.


    Criminal Convictions

    Due to the nature of the work for which you are applying, this position is exempt from the provision of section 4 (42) of the rehabilitation of offenders act 1974 (exemptions order) 1975. as a result you are not entitled to withhold information about criminal convictions which for any other purposes are ‘spent’ under the Act. In the event of employment any failure to disclose such convictions could result in instant dismissal or disciplinary action by senior management to staff. Any such information received will be treated in the strictest confidence and will only be taken into consideration in relation to an application for position to which the order applies. The position that you have applied for allows for substantial access to vulnerable adults and, any offer of employment will be subject to police and medical checks. Your written consent for these will be requested (if appropriate) at a later stage.

    Where Did You First See/Hear About This Vacancy.

    Local Newspaper (Please Specify Below)Website/Internet (Please Specify Below)Job CentreInternal AdvertCurrent EmployeeOther