Dear Candidate,

Thank you for your time in applying for a position at IDEM Living.

IDEM Living is a provider of support to adults and children with learning disabilities, autism and complex needs.

Once you have completed your application form, please either email your form to or post your application to Newlands Hey School, 1a Huyton Hey Road, Liverpool L36 5SE. Once your application has been shortlisted, we will arrange an interview, if successful at interview, arrangements will be made for your induction.

The following policies are available upon request

Recruitment of ex-offenders

Storage and Retention of Information Policy

Equal Opportunities

Yours Sincerely

Rob Gillespie

Rob Gillespie

Managing Director

Application Form

Please use black ink and write clearly

Section 1 - Job Details

Post Applied For
Location

Section 2 – Your Details

Title
Forename
Surname
Known As
Previous Surname
Address
Telephone Number
Mobile Number
Email address

Section 3 – Employment History.

Please give full employment details since leaving school to present day, continuing on a separate sheet of paper if necessary.

Name of Company
Contact Name
Contact Number
Address
Post Code
Dates of Employment
Please provide a description of your roles and responsibilities
Reason for leaving
Name of Company
Contact Name
Contact Number
Address
Post Code
Dates of Employment
Please provide a description of your roles and responsibilities
Reason for leaving

Section 3 Continued

Name of Company
Contact Name
Contact Number
Address
Post Code
Dates of Employment
Please provide a description of your roles and responsibilities
Reason for leaving
Name of Company
Contact Name
Contact Number
Address
Post Code
Dates of Employment
Please provide a description of your roles and responsibilities
Reason for leaving


Section 3 Continued: Gaps in employment

Please insert here details of any periods when you were not in employment, giving dates and reasons

Date from / Date to / Reason

Section 4 – School, Training and Qualifications

Please provide details your secondary school and any other further or higher education establishments. In the second section please also provide details of your qualifications and training.

School/ College / Start date / End date
Subject/Training Course / Level / Date Achieved/Expected

Section 5 - Medical History

How many periods of absence have you had in the past 2 years?
How many days off sick have you had in the past 2 years?
Please use this space if you wish to make any additional comments about your medical history

Section 6 - Additional Information

Please use the space below to tell us more about your experience and why you are interested in this role

Section 6 - continued

Section 7 - DBS

All potential employees must complete and receive a DBS certificate before beginning employment

Have you completed a DBS/CRB form before? If yes, when was it approved?
Please provide any other additional information regarding your DBS that you believe to be relevant. Have you registered to the DBS Update service?

Section 8 – References – Please include your most recent employer

Name of Contact
Company Name
Contact Number
Email address
Address
Name of Contact
Company Name
Contact Number
Email address
Address
Name of Contact
Company Name
Contact Number
Email address
Address

We must receive two verified references before you begin your employment. References must be from your Line Manager

References may be requested before a conditional job offer is requested, please indicate your preference

Yes / No
Reference 1
Reference 2
Reference 3

Are you willing to work evening, weekends and nights?

Is there a limit of the number of hours you can legally work in the UK?

By signing the below, you assure Idem Living that the information given is accurate and up to date. You also confirm your understanding that you not be able to start working until we have received a DBS certificate, two verified references, proof of your right to work in the UK and you have completed your induction. You also agree that the first six months of your employment form a probationary period

Signature / Date

Section 9 - Office Use

Application Shortlisted
Interview Successful
Vacancy Confirmed
Outcome Notified
Induction Booked
DBS Completed
DBS Received
1 Reference Received and Verified
2 Reference Received and Verified

Terms and Conditions of Contract - To be completed by a Manager

Based At
Line Manager
Rate of Pay
Able to work Evenings, Nights and Weekends
Holiday Entitlement

Confirm to issue a contract with the above terms and conditions

Signed
Date
Job Title

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