Job application form
Please answer all questions.
Position applied for
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Service
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The service the job vacancy is within, for example 'LMWS'/'Schools'.
Personal details
Name
*
First Name
Last Name
Pronouns
Mobile phone number
*
Home phone number
Email address
*
Confirmation Email
please confirm email address
Languages spoken
Please indicate when you would be able to start and your preferred days / hours of work
*
0/100
Education & Training
Academic courses - please list any education you have undertaken, and the qualifications obtained:
Qualification
Place of Study
Year Obtained
Qualification
Place of Study
Year Obtained
Qualification
Place of Study
Year Obtained
Current employer name and address
*
*
Professional Development
Please give details of relevant professional development training courses undertaken:
Course Title
Training Provider
Duration
Year Obtained
Course Title
Training Provider
Duration
Year Obtained
Professional development - please give details of relevant professional development training courses undertaken:
*
Are you undertaking a course of study at present?
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Yes
No
If yes, please give details
Details of any additional academic qualifications or training courses:
Are you accredited by a professional organisation?
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Yes
No
If yes, please give details
0/50
Details of current membership of any professional organisation(s)
0/50
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Employment history
Most recent first. Please include voluntary and unpaid work.
Current employment
Current employer name and address
*
Position held
Start/end date
Full-time equivalent salary
Summary of role/duties
0/100
Reason for leaving
Previous employment 1
Previous employer 1 name and address
Position held
Start/end date
Full-time equivalent salary
Summary of role/duties
0/100
Reason for leaving
Previous employment 2
Previous employer 2 name and address
Position held
Start/end date
Full-time equivalent salary
Summary of role/duties
0/100
Reason for leaving
Previous employment 3
Previous employer 3 name and address
Position held
Start/end date
Full-time equivalent salary
Summary of role/duties
0/100
Reason for leaving
Brief summary of any other relevant, previous positions held
0/400
Please state the reason(s) for any gap(s) in employment
0/100
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Life experience
Is there anything else you have done that you wish to tell us about? This may include work experience, unemployment, caring for a child/relative/friend etc.
Tell us here ...
Statement of application
After reading the job description and person specification please complete this section. Please demonstrate how you meet the criteria set out in the person specification. The information you provide in this section will be used in assessing your application for the post. A decision about whether or not to interview you will be largely based upon this statement. Make sure you back your statements up with clear evidence of your knowledge, skills and experience. You can use examples from your lived experience, voluntary roles, previous jobs or your studies.
Statement
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0/10000
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Declarations
As the post you are applying for involves contact with children and/or vulnerable groups, you are required to declare any convictions you have, even if they would otherwise be regarded as ‘spent’, under the rehabilitation of Offenders Act 1974 (Exemptions) Order S11975 Schedule 1 Part 2 (amended by S1 1986).The successful applicant will be asked for evidence of an enhanced disclosure within the last two years from the Disclosure and Barring Service (formerly CRB), and may be asked to complete a new disclosure. Each applicant will be considered on their own merits and having a criminal record will not necessarily prevent your application from being considered.
Have you at any time received, or have pending, a court conviction (including any cautions)?
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Yes
No
If yes, please give details of all convictions, cautions, reprimands or warnings (including ‘spent’ convictions)
A check as to the existence and content of a criminal record will be requested from the Disclosure and Barring Service after a person has been selected for appointment to this post. Refusal to agree to a check being made could disqualify you from being considered for the appointment. You are therefore asked to sign the statement below to confirm your agreement, if you are selected for the appointment, to a check being made on any criminal record applicable to you. Each applicant will be considered on their own merits and having a criminal record will not necessarily prevent your application from being considered.
Signature
*
I agree, if I am selected for this appointment, to checks being made with the Disclosure and Barring Service for any record of convictions or cautions against me. I am aware that such information as appropriate for Enhanced Disclosures will be made available.
Date of signature
*
-
Day
-
Month
Year
Date
Are you eligible to work in the UK?
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Yes
No
Do you need a work permit to take up this post?
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Yes
No
Do you have a full driving licence?
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Yes
No
Do you have use of a car?
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Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you related to any trustee or employee of Northpoint?
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Yes
No
If yes, please give details
Information in this application may be processed for purposes registered by the Employer under the Data Protection Act 1998. I hereby give my consent to Northpoint, Barca and Touchstone processing the data supplied in this application form for the purpose of recruitment and selection.
Declaration 1: I declare that the information I have given in this application is accurate and true. I understand that providing misleading, false information or significant omission may be sufficient grounds for the offer of employment being withdrawn, or dismissal.
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I agree
Declaration 2: I understand that any offer of employment is subject to satisfactory pre-employment checks, including references, right to work in the UK, and a DBS enhanced disclosure check.
*
I agree
Declaration 3: I confirm that the tick in this box is a valid means of establishing the authenticity of my signature to this application. I understand that Northpoint Wellbeing Limited will hold this acceptance data on their files.
*
I agree
Date of signature
*
-
Day
-
Month
Year
Date
A copy of all the information contained in this application will be emailed to me on submission of this completed form.
*
I agree
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