Personal Details

Applying for

Date of Birth

Date

Title

First Name

Last Name

Full Address

Address 1

Address 2

City

Postal Code

County

Country

Home Telephone

Mobile Telephone

Contact Email

National Insurance Number

Driving License Number (If Applicable)

What is your DBS Number? (if any)

Do you have access to a car that can be used for work purposes and business insurance?

Yes

No

Do you have any current driving endorsements?

Yes

No

Do you require a work permit?

Yes

No

Education

Please provide a full breakdown of all education from the age of 11yrs

Education Entries

Training

This includes government training schemes, apprenticeships, short courses, projects and secondments. Please also include professional training and give date of completion.

Training Entries

No relevant training to add?

Current Employment

Employer Name

Position whilst in Employment

Salary

Address of Organisation

Address 1

Address 2

City

Postal Code

County

Country

Start Date

Current Employment Start Date

End Date

Currrent Employment End Date

Briefly describe your main roles and responsibilities:

Previous Employment

Include permanent and temporary work, voluntary work and any work experience from leaving school

Previous Employment Entries

Gaps in Employment History

Please state information around any gaps in your employment in chronological order.

References

Please provide two references. One must be your present or last employer (where applicable) and another second employer.

*References will be sought to cover all positions whereby you have worked with children, young people and vulnerable adults. Note: We reserve the right to seek references at any point in the recruitment process and from any previous employers listed in the ‘Previous Employment’ section of this form.

A job offer will not be made without a minimum of two satisfactory references.

Employee Referee Details

Warnings and Disciplinary

Have you ever been dismissed or have you ever resigned whilst in the process of any disciplinary proceedings?

Have you ever been the subject of any allegations in relation to the safety and welfare of children, young people or vulnerable adults either substantiated or unsubstantiated?

Absent from Work (Last 12 months)

Please give the number of days and reason for any sickness/absence days taken during the last 12 months.

Absent Entries

No absent entries to add?

Convictions

You are required to declare any criminal convictions (including bind over and cautions) in accordance with the Rehabilitation of Offenders Act 1974. The post you have applied for carries exempt status under the provisions of the Act for which you are required to declare any convictions regardless of whether or not the time limit has elapsed.

All appointments are subject to an enhanced DBS check.

Failure to disclose any information relating to criminal convictions may disqualify your application or result in dismissal without notice.

**N.B. Declaration of convictions will not necessarily bar you from employment.

Have you ever been formally cautioned, or do you have any previous criminal convictions?

Yes

No

If Yes please provide details, including dates and conviction details

Are there any alleged offences against you that are currently being investigated or are outstanding?

Yes

No

Disclosure and Barring

Successful applicants will be subject to an enhanced DBS check (formally known as CRB) and will be subscribed to the DBS update Service. FtF will carry out these checks on your behalf.

Are you giving us your consent to carry out the necessary checks?

Yes

No

Declaration of Interest

Do you have any relationships with any person employed by or connected with Footsteps to Futures?

Yes

No

Declaration

I declare that the information given both on this application form, disclaimer form and the attached equal opportunities monitoring form is true and correct. I understand that any false or misleading information may disqualify my application or may render my Contract of Employment, if I am appointed, liable to termination.

Applicant Name

Signature

Please use finger or cursor to draw your signature below

Date of Application

Data Protection Act 1998

Footsteps to Futures will only process the information you have provided in this form for the purpose of recruitment and selection and, if you are successful in securing this position, for purposes relating to your employment.

We will not disclose this information about you to outside organisations or third parties unless there is a legal requirement to do so, or for the prevention and detection of fraud.

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