Position Applied For(Please Specify)

Recruitment Pack

Applicant’s Name:

Position applied for(Please specify)

Where did you see this vacancy?

Applicants Name

Thank you for requesting an application form for the above vacancy. We will use this form to help decide your suitability for the job so please make sure that it is accurate and complete. You should complete all sections in black ink or typeface to assist with photocopying the form. Please do not send any curriculum vitae or testimonials unless asked to do so.

If you would like a copy of the form in large print, on audiotape, in Braille or in Excel computer format please contact us.

Please return your completed form no later than the closing date to the address shown below. Late applications may not be considered.

Return to:

/

Or

Focus Birmingham

Human Resources Department

48 – 62 Woodville Road
Harborne

Birmingham

B17 9AT

The information on this application form will be used for the purposes of selection and the forms will be retained for at least twelve months. The application form of the successful candidate will form part of their employee file and may be used for a number of employment related purposes.

CONFIDENTIAL WHEN COMPLETED

Supporting people with visual impairments and other disabilities, together with their carers, to live fulfilling and independent lives by providing services that reflect their wants and needs.

1 – Personal Details

Surname/Family Name: / Preferred form of address (e.g. Mr, Mrs, etc.):
Forename(s): / Are you over 18? (Please tick if yes):
Previous name(s):
Home telephone: / Work telephone:
Mobile number: / Email address:
National Insurance number:
Address:
Postcode:

Disability

Focus Birmingham undertakes to interview disabled people who meet the minimum/essential criteria. Disability is defined as any physical or mental impairment, which has a substantial and long term (over 12 months) adverse effect on your ability to carry out normal day to day activities.

Please confirm therefore whether you have a disability:

Yes /  / No / 

Canvassing and Relationships

If you are related to or have a close personal relationship with an elected Member or an employee of Focus Birmingham, please state their name, status within the organisation and relationship to you.

Canvassing may lead to disqualification for appointment.

2 – Education, Training and Qualifications

Please give brief details of all training and other courses you have undertaken. You may be asked to provide documentary evidence of professional qualifications you will be asked to bring documentary evidence of care qualifications, including first aid, if shown below.
Name of school/college/ university attended. / Qualifications including grades. / Date obtained.
a) Schools (after age 11):
b) Further or Higher Education (full or part-time):
c) Professional or other courses (including training courses attended, NVQs etc.):
d) Current membership of any professional organisations:

Driving Qualifications

(all applicants should complete but this will only be used where relevant).

Do you hold a current, full driving licence?

Yes /  / No / 

Work Permit

Yes /  /

No

/ 

Do you need a work permit to work in this country?

3 – Employment and/or Work Experience

Please indicate any previous experience, whether paid, unpaid or voluntary, starting with the most recent.

a) / Current or most recent employer’s name and address, including work base address: / Present Salary: / Date Started: / Date Finished:
Period of Notice:
Duties:
Position Held:
b) / Employer/Organisation
(most recent first): / Position held and brief description of duties and responsibilities: / Dates / Reasons for leaving and final salary:
From / To

4 – Additional Information

Please explain how your skills, abilities, experience and achievements to date (including leisure and voluntary) would make you a suitable candidate for this post. Please refer to the criteria on the enclosed Person Specification:
Continue on a maximum of one additional A4 sheet if necessary.

5 – Convictions/Disqualifications

Please give details and dates of any criminal convictions or driving offences.

Focus Birmingham does not wish to discriminate against ex-offenders. However, due to nature of work within the charity under the Rehabilitation of Offenders Act 1974 applicants must declare all convictions whether spent or not under the act. Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position and the circumstances and background of your offences.

You must tick one of the two boxes below:

 /

I have a conviction or disqualification and I attach an additional sheet providing details or dates.

Or

 /

I do not have any convictions.

Please note that all successful candidates will be asked to complete a disclosure application to enable checking with the Disclosure and Barring Service.

6 – References

Please give details of two people, one of which should normally be your current line manager, who are able and willing to comment on your suitability for this job.

Referee 1 (Please tick as appropriate)
Work Reference  Character Reference
Title (e.g. Mr, Miss):
Name: Position:
Company Name: Address:
Postcode:
Telephone number: Fax number:
Email:
Relationship to you (e.g. Manager, Colleague):
Dates employed: From To:
Do you want to be consulted before this referee is approached?
Yes /  /

No

/ 
Referee 2 (Please tick as appropriate)
Work Reference  Character Reference
Title (e.g. Mr, Miss):
Name: Position:
Company Name: Address:
Postcode:
Telephone number: Fax number:
Email:
Relationship to you (e.g. Manager, Colleague):
Dates employed: From To:
Do you want to be consulted before this referee is approached?
Yes /  /

No

/ 

To comply with recent requirements within the Care Standards, we may contact your referees before the interview process. Please tick the box if you do not consent to this:

7 – Declaration

I have read the information given to me about this job. I confirm that I do not have any medical impairment that, without reasonable adjustment, would prevent me from carrying out the duties of this job. I declare that all the information given in this application form is correct and complete. I understand that if any information I have provided is found to be untrue, any offer may be withdrawn or any contract of employment may be terminated.

Signed: / Date:

Registered Charity No. 1065745. Registered Company No. 3353444

Policy statement on the recruitment of ex-offenders

As an organisation using the Disclosure and Barring Service (DBS) to assess applicants’ suitability for positions of trust, Focus Birmingham complies fully with the DBS Code of Practice and undertakes to treat all applicants for positions fairly. It undertakes not to discriminate unfairly against any subject of a Disclosure on the basis of conviction or other information revealed.

Focus Birmingham is committed to the fair treatment of its staff, volunteers, potential staff or users of its services, regardless of race, gender, religion, sexual orientation, responsibilities for dependants, age, physical/mental disability or offending background.

We have a written policy statement on the recruitment of ex-offenders, which is made available to all Disclosure applicants at the outset of the recruitment process.

We actively promote equality of opportunity for all with the right mix of talent, skills, and potential and welcome applications from a wide range of candidates, including those with criminal records. We select all candidates for interview based on their skills, qualifications, and experience.

A Disclosure is requested for every member of staff and volunteer. All application forms, job adverts and recruitment briefs will contain a statement that a Disclosure will be requested in the event of the individual being offered the position.

We encourage all applicants called for interview to provide details of their criminal record at an early stage in the application process. We request that this information is sent under separate, confidential, cover to a designated person within Focus Birmingham and we guarantee that this information is only be seen by those who need to see it as part of the recruitment process.

Due to the nature of the work in Focus Birmingham we will ask questions about your entire criminal record i.e. “spent and unspent convictions” as defined in the Rehabilitation of Offenders Act 1974.

We ensure that all those in Focus Birmingham who are involved in the recruitment process have been suitably trained to identify and assess the relevance and circumstances of offences. We also ensure that they have received appropriate guidance and training in the relevant legislation relating to the employment of ex-offenders, e.g. the Rehabilitation of Offenders Act 1974.

At interview, or in a separate discussion, we ensure that an open and measured discussion takes place on the subject of any offences or other matter that might be relevant to the position. Failure to reveal information that is directly relevant to the position sought could lead to withdrawal of an offer of employment

We make every subject of a DBS Disclosure aware of the existence of the DBS Code of Practice and make a copy available on request.

We undertake to discuss any matter revealed in a Disclosure with the person seeking the position before withdrawing a conditional offer of employment.

Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position and the circumstances and background of your offences.

The Benefits of working for us…

Supporting people with visual impairments and other disabilities, together with their carers, to live fulfilling and independent lives by providing services that reflect their wants and needs.

Equal Opportunities Monitoring Form

Focus Birmingham is committed to the elimination of all forms of unjustifiable discrimination. Focus Birmingham will actively pursue equality of opportunity for all by seeking to ensure that all prospective and existing employees are treated fairly. Personal circumstances and characteristics will only be taken into account when they can be justified as being essential to employment (as in genuine occupational qualifications). To enable Focus Birmingham to constantly monitor itself to ensure this commitment is fulfilled, we would ask all applicants to complete the questions detailed below.

This information will be treated as completely confidential and will be used for monitoring purposes only. This information will be detached from the application form on receipt and will not be considered during the selection process.

Please tick as appropriate:

1)Which one of the following do you consider to be your ethnic origin?

(tick one box only, see below for explanatory notes)

British white / Irish white
Other white / Black (Caribbean)
Black (African) / Other black

Mixed white and black African

/ Mixed white and Asian
Mixed white & black Caribbean / Other mixed
Asian (Indian) / Asian (Pakistani)
Asian (Bangladeshi) / Other Asian
Chinese
Other ethnic group (please describe)
2) Are you / Male /  /

Female

/ 
3) Do you have a disability? / Yes /  /

No

/ 

For the purposes of this form, a disability is defined as any physical or mental impairment that has a substantial and long-term (over 12 months) adverse effect on your ability to carry out normal day-to-day activities.

4) Please tick the age band currently applicable to you:

Up to 19  / 20 – 29  / 30 – 39  / 40 – 49  / 50 – 65  / Over 65 

Monitoring form explanatory notes: The ethnic groups set out above are those recommended by the Commission for Racial Equality and were used in the 2001 census. Ethnic origin questions are not about nationality, place of birth or citizenship; they are about colour and broad ethnic group. UK citizens can belong to any of the groups indicated. If you are descended from more than one ethnic group, please tick the group to which you consider you belong – or tick the ‘other ethnic group’ box and give details in the space provided above.