Post Ref No ……… Applicant Ref No ………

CONFIDENTIAL

KINGDOM HOUSING ASSOCIATION LIMITED

APPLICATION FOR EMPLOYMENT

POST(S) APPLIED FOR: / Support Worker (Open Recruitment)
Please tick / 20 hrs+ contract / Bank Hours Contract

Part 1 – Not shared with the Recruiting Department

  1. Personal Details

Surname / Home Tel No
Forename(s) / Mobile No
Home Address / Email Address
(If you provide us with your email address we will normally contact you this way.)
Post Code
  1. Police Check / PVG Scheme

Do you have any criminal convictions or pending charges?YesNo

If the appointment is subject to a Disclosure Scotland / PVG Scheme check (see the advert) and, depending on the type of Disclosure, some spent convictions may be reported to us. (This will not necessarily discount you from being considered for the post.)

Are you registered with the PVG Scheme to work with Protected Adults?YesNo

If yes, please provide your PVG Member Number
  1. Referees

One must be your present or most recent employer or school/college. We will not normally accept references from relatives/friends. We reserve the right to request more than 2 references. If you provide your referee email addresses we will normally contact them this way.

Name / Name
Position / Position
Company (if applicable) / Company (if applicable)
Relationship to You / Relationship to You
Address / Address
Telephone No / Telephone No
Email / Email

Do you give us permission to contact your referees?YesNo

(If you don’t give permission, we will assume you are happy for us to contact your referees if you are provisionally offered and accept employment/work with us.)

Are you available for Interview at any time?YesNo

If “No”, please provide details of non-availability: ………………………………...

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Post Ref No ……… Applicant Ref No ………

CONFIDENTIAL

  1. Granting of Benefits to Close Relatives / Family Members

We are required by law to ask you this and this will not necessarily discount you from being considered for the post. A close relative is defined as a spouse, co-habitee, parent, grandparent, child, brother or sister. Are you a close relative or family member of a current employee or member ofour Committee of Management? Yes No

If “Yes”, please explain your relationship and provide their name: ………………………………………

  1. Equality and Diversity Monitoring

In order to monitor the effectiveness of our Equality and Diversity Policy, we request all applicants to complete this section, although it is not compulsory to do so. To which ethnic group do you belong?

White: / Asian, Asian Scottish or Asian British:
Scottish / Indian
Other British / Pakistani
Irish / Bangladeshi
Gypsy / Traveller / Chinese
Polish / Any Other Asian Background
Any Other White Background
Mixed or Multiple Ethnic Background:
Black, Black Scottish or Black British:
Caribbean / Other Ethnic Background:
African / Arab, Arab Scottish or Arab British
Any Other Black Background / Any Other Group

Are you? Male Female How old are you? ……………….

Do you consider yourself disabled, as defined by the Equalities Act 2010? YesNo

If yes, please specify the nature of your disability: ………………………………………………………….

Where did you see this post advertised?Newspaper (Specify) Job Centre

KHA Website Other (Specify)

  1. Declaration

I declare that the information given in Parts 1 and 2 of this application for employment is true and complete to the best of my knowledge. If any of this information given by me in this form or in support of my application is untrue, I recognise that any offer of employment/work may be withdrawn, or my employment with Kingdom ended.

Signed: …………………………………………………………… Date: ……………………………………..

Please refer to our Data Protection Statement at the end of Part 2.

Completed application forms should be sent (or emailed) to Kingdom Housing Association Limited, Resources Department, Saltire Centre, Pentland Court, Glenrothes, Fife, KY6 . Web:

Scottish Charity No: SC000874Tel: 01592 631661Fax: 01592 631991

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Post Ref No 236……. Applicant Ref No ……………………......

CONFIDENTIAL

POST(S) APPLIED FOR: / Support Worker (Open Recruitment)
Please tick / 20 hrs+ contract / Bank Hours Contract

Part 2 – Assessed by the Recruiting Department

1.Qualifications / Memberships

Please indicate below qualifications gained at School, College or University. You need only provide the date awarded for College or University qualifications or time served apprenticeships.

Subject / Detail / Qualification and Status of Membership (if applicable) / Grade / Date Awarded

2.Courses Attended / Other Relevant Specialised Training / Knowledge

  1. Employment History

This is your present or most recent employment, voluntary work or work experience.

Name and Address of Employer
Nature of Business
Post Held
Dates of Employment / From / To
Salary / Current / Expected
Notice Required
Duties and Responsibilities
Reason(s) for leaving or wishing to leave

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  1. Previous Employment

Please start with most recent and include any periods not in paid employment, voluntary work or work experience. Continue on an additional sheet, if necessary.

Dates (Month/Year)
From To / Name and Address of Employer / Position Held, Description of Duties and Responsibilities / Reason(s) for Leaving
  1. Suitability for the Post

Please refer to the person specification provided in the application pack you received and comment on how you meet the criteria (continue on a separate sheet, if necessary).

Essential Criteria / Your skills, qualities and experience against each of the person specification criteria
E 1Previous experience or interest in supporting adults live an independent life in the community.
E 2The ability to develop professional working relationships and work as part of a team in unsupervised settings.
E 3The ability to work with people with a disability
E 4Ability to cope with the physical and emotional demands of a Support and Care setting.
E 5The ability to understand and promote confidentiality.
E 6Good communication skills (written & oral).
E 7The ability to work flexible hours; ie shift working will be required and, to meet the needs of the individual services, split-shift working; sleep in and waking night duties may be required.
E 8SVQ 2 in Social Care or commitment to gain this qualification.
E 9A current driving licence and use of a car for work.
(Not required for Bank contracts)
Desirable Criteria / Your skills, qualities and experience against each of the person specification criteria
D 1Knowledge of health and safety issues, including risk assessments.
D 2Hold a qualification in SVQII in Care.
  1. Further Information

Please use the space below to tell us why you are applying for this position and any other relevant information you would like us to know.

DATA PROTECTION STATEMENT

We will use the information you give in Parts 1 and 2 of this form, and in any supporting evidence you send us, to process your application for employment. We may pass the information to other agencies or organisations as allowed by the law and in accordance with our Registration with the Information Commissioner. Kingdom is registered as the Data Controller under the Data Protection Act with the office of the Information Commissioner. As the Data Subject you have the right to access the information we hold on you. If you wish to access this right please contact our office and ask for a Data Subject Access Request Form.

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