Job Application Form

Successful applicants will be asked to provide an Enhanced Disclosure Certificate, detailing all criminal convictions against their name, as supplied on application from The Disclosure Barring Service. Disclosure information will not be used for any other purpose than in connection with this application and a criminal record will not necessarily be a bar to employment.

Please answer if stated as an essential or desirable requirement on the person specifications.

Please list in order (most recent job first) the organisations you have worked for, full-time and part-time, paid and unpaid, including relevant voluntary work and include any periods of non-employment.

Please include details of studies undertaken and qualifications achieved from secondary education onwards:

Do you hold current certified certificates in?

The information you provide in this section is important in assessing your application. Please use the space to explain your reasons for applying for the post, showing how your skills, experience and personal qualities relate to the job requirements as set out in the job description and person specification. These may have been gained through previous employment, voluntary/community work, spare time activities or training. Please include details of membership of relevant professional associations, and anything else which you think is appropriate to this application.

Regulation 21, Health and Social Care Act 2008 (Regulated Activities) Regulations 2008 requires that all employees who work in Health & Social Care are both physically and mentally fit to undertake their duties.

Under the Equality Act 2010, the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long-term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at: www.gov.uk/definition-of-disability-under-equality-act- 2010.

The Rehabilitation of Offenders Act 1974 aims to promote equality of opportunity and is committed to treating all applicants fairly regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. Supported Living Services Ltd undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared. Answering 'yes' to the question below will not necessarily prevent your employment. This will depend on the relevance of the information you provide in respect of the nature of the position and the particular circumstances.

Please provide names, addresses and telephone numbers for referees below who we may approach for a reference. In line with CQC requirements, we require references (or other satisfactory evidence as the employer may determine) from all previous employers concerned with the provision of services relating to health or social care, or children or vulnerable adults which should include details of why their employment came to an end (note that this is not time limited). If your previous employment does not concern the provision of services relating to health or social care, or children or vulnerable adults, you must provide references from your two most recent employers. Please provide two character references if you are unable to obtain two professional references, e.g. in the case of an applicant who has been raising children for ten years. All will be contacted. Therefore, please inform the referees of the fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.

Please add here your reasons for applying. You should refer to the job description and person specification to guide you. It would also be of value to describe particular strengths and talents that set you apart from others as well as including skills gained from work, home and other activities.