Application Form

All disabled applicants who meet the essential criteria in the person specification will be shortlisted for interview and given the opportunity to outline any reasonable adjustment that may be required

Canvassing directly or indirectly will disqualify you

EMPLOYMENT

Present or most recent employment details

PREVIOUS EMPLOYMENT

Please place your most recent employment first, include any voluntary work, and account for any gaps e.g. for periods of unemployment, child care etc. if this does not cover your FULL employment history you will be asked for further details after being invited to interview.

Natural Breaks reserves the right to contact all or any employers you have listed below, in order to verify the employment details sorted.

QUALIFICATIONS - SECONDARY EDUCATION

FURTHER EDUCATION - university, college, part time or work related courses

All information contained in this form will be treated as strictly confidential. By supplying information, you will also be indicating your consent to the information being processed for all employment purposes as defined in the Data Protection Act 1998, and any verification checks which may be made. However, we must protect the public funds we handle and so we may use the information you have provided on this form to prevent and detect fraud. We may also share this information, for the same purpose with other organisations which handle public funds. (Revised March 2004).

SKILLS AND EXPERIENCE

REFEREES

Give details of two people to who you are not related and to whom reference can be made; one has to be your current employer, or if you are currently unemployed, your last employer, or in the case of school leavers, your tutor.

REFEREE 1

REFEREE 2

REHABILITATION OF OFFENDERS ACT 1974

The nature of the post means that you will be involved with vulnerable adults or children and therefore the post is exempt from the provisions of the above Act. It is necessary to disclose all convictions , cautions or court martial that you have had. Natural Breaks seeks Enhanced Disclosures with the Disclosure and Barring Service for all prospective employees. Failure to disclose may lead to the withdrawal of an offer of employment.

If you ticked yes to either of the above please complete below. Any information will be treated confidentially and the possession of a conviction does not necessarily mean that you will not be short-listed for the post.

PROTECTION OF CHILDREN AND VULNERABLE ADULTS DECLARATION

The underlying principle in UK legislation and guidance relating to vulnerable adults and children is the welfare and safety of the individual is paramount. Natural Breaks therefore require all prospective employees to complete and sign the following:

I confirm that the above information given by me is correct and that I consent to my personal data being processed and kept for the purpose described above in accordance with the Data Protection Act 1998

DECLARATION OF PHYSICAL AND MENTAL FITNESS

Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and subsequent CQC Regulations all prospective employees are required to be physically and mentally fit to carry out the role.

Please complete the following statement

declare that I am physically and mentally fit for the purposes of the work as laid down in the job description

PERMISSION TO WORK IN THE UK

Under section 8 of the Asylum and Immigration Act 1996, it is a criminal offence to employ anyone who does not have permission to work in the UK. All applicants invited to interview will be required to provide documentary evidence of their right to work in the UK. ALL APPLICANTS regardless of their nationality are required to complete this section.

Please sign and date where indicated. If no, please answer the following questions:

PLEASE READ BEFORE SIGNING

I declare that by signing this form I am stating that I am legally entitled to work in the UK with or without the necessary permission from the Home Office or any other relevant authority. if I have received permission I have included any copies of all relevant documentation. I acknowledge that if I am found to be working without the relevant permission, my employment will be terminated with immediate effect and details passed on to the relevant authorities.

DECLARATION

I declare the information contained in this application form is to the best of my knowledge correct

All information contained in this form will be treated as strictly confidential. By supplying information, you will also be indicating your consent to the information being processed for all employment purposes as defined in the Data Protection Act 1998, and any verification checks which may be made. However, we must protect the public funds we handle and so we may use the information you have provided on this form to prevent and detect fraud. We may also share this information, for the same purposes, with other organisations which handle public funds. (Revised March 2004)