Age Cymru Gwent

CONFIDENTIAL

APPLICATION FORM

Please complete the whole application form. Please note CV’s are not acceptable.

Position applied for______

How did you hear of the vacancy?______

For office use only: Applicant no

1.PERSONAL DETAILS

FORENAME / SURNAME

FULL POSTAL ADDRESS

POST CODE

HOME TEL NO:

DAY TIME TEL NO:

MOBILE NO:

E MAIL:

2.SUPPORTING INFORMATION

Please pay particular attention to this section. It is the most important part of your application, as it is where you tell us what makes you suitable for this post. Your application will be judged against the Job Description, which is the list of essential requirements for the post. You should refer to and address each point of the Job Description, giving details of what skills, experience and knowledge you have in each of these areas.

Always be specific. Don’t use general phrases such as “I have the necessary skills….” or I am confident I can do the job well….”. The shortlisting panel need to know why and how based on the evidence you provide. You should include relevant details of any current and previous jobs. However, experience gained outside paid employment may be just as important. For example, you may have done voluntary work in the community or have skills acquired through household administration.

PLEASE ATTACH SEPARATE SHEET AS NECESSARY.

3.EDUCATION

PLEASE LIST THE ACADEMIC QUALIFICATIONS WHICH YOU HOLD
Proof of qualifications may be required
TRAINING
PLEASE LIST ANY VOCATIONAL QUALIFICATIONS WHICH YOU HAVE INCLUDING ANY RELEVANT TRAINING
Proof of Vocational Training may be required
ARE YOU PRESENTLY STUDYING FOR ANY QUALIFICATIONS? YES/NO
IF YES, PLEASE PROVIDE DETAILS
4. DO YOU BELONG TO ANY PROFESSIONAL ORGANISATION? YES/NO
If yes, please provide details of the Organisation, the level of your membership and how
obtained (examination or qualification)
5. IF YOU HAVE UNDERTAKEN ANY FORM OF WORK EXPERIENCE/
YOUTH TRAINING PLEASE PROVIDE THE FOLLOWING DETAILS:-
EMPLOYER / FROM / T0 / DUTIES UNDERTAKEN
6. PLEASE STATE ANY INTERESTS AND VOLUNTARY WORK ACTIVITIES
(Clubs, Societies, Sports, Games, Hobbies etc).
7. PRESENT JOB
Name and Address of Employer:
Job Title: Length of Notice Required:
Date of Appointment:
Brief description of duties and responsibilities. Separate sheets may be added.
8. PREVIOUS EMPLOYMENT, please list all jobs (most recent first). Where there are any gaps in employment, please detail the reasons. If there are unexplained gaps, we may not be able to consider you.
Occupation including
job title / From / To / Name, Address and Tel No
of Employer / Reason for
leaving

Please continue on separate sheet if necessary.

Please tick as appropriate
9. DO YOU CURRENTLY HOLD A FULL DRIVING LICENCE? YES NO
Details of any endorsements______
Would you have access to a vehicle for the purposes of carrying out employment with
Age Cymru Gwent. YES NO

10. REFERENCES (at least one of which should be your present/last employer).

1 / 2
Name
Status/Position held by
Referee
Address
Tel No

References are normally taken up as part of the interview process and we are required to hold two references before we can appoint. if you have any objections to references being taken up from your present employer as part of the interview process, please tick box and provide an additional referee. Please note that the referee may not be a member of your

family.

11. ADDITIONAL INFORMATION
(b) Have you ever been convicted, cautioned, reprimanded or warned for any criminal offence?
Yes No
Please see the attached statement on the Recruitment of ex Offenders.Please note that, as an agency working with vulnerable people, certain roles are considered exempt from the Rehabilitation of Offenders Act 1974 and any convictions must be declared; none may be considered spent.

Please note that certain employees of Age Cymru Gwent are required to be checked by the Disclosure and Barring Service. In signing this application form you are agreeing to a disclosure, if it is appropriate to the post you are applying for. Please see the attached statement on the Rehabilitation of Offenders.

I confirm that to the best of my knowledge all information provided is accurate.

Signature______

Name (Please print)______

Tel: 01633 763330

Fax 01633 259426

E Mail

This form should be sent to:

The Human Resources Department

Age Cymru Gwent

12 Baneswell Road

Newport

South Wales,

NP20 4BP

RECRUITMENT POLICY STATEMENT

RECRUITMENT OF EX-OFFENDERS

As an Organisation using the Disclosure and Barring Service (DBS) Disclosure service ( formerly CRB)to assess applicants’ suitability for certain positions, Age Cymru Gwent 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 a basis of conviction or other information revealed.

An enhanced disclosure is required for certain positions in the Organisation, and all application forms, job adverts and recruitment briefs will contain a statement that a Disclosure will be required, and whether or not the position is exempt from the Rehabilitation of Offenders Act 1996. Disclosures will only be sought in the event of the individual being offered the position.

We require all applicants to declare details of their criminal record at an early stage of the application process. We reserve the right to ask questions about the whole of your criminal record, including offences that may be spent under the Rehabilitation of Offenders Act 1974.We guarantee that this information is only to be seen by those who need to see it as part of the recruitment process. It should be noted, however, that failure to declare any offence may lead to the withdrawal of any conditional offer of employment.

From 12 October 2009, if Age Cymru Gwent remove someone they employ or for whom they are responsible, from regulated activity or controlled activity, or if they leave while under investigation for allegedly causing harm or posing a risk of harm, Age Cymru Gwent is legally obliged to refer this information to the ISA. Failure to do so is an offence and will carry a significant penalty. Further details can be found on the Gov.co.uk website.

We ensure that all DBS registered countersignatories in Age Cymru Gwent 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 guidelines and training in the relevant legislation relating to the employment of ex-offenders, e.g. the Rehabilitation of Offenders Act 1974.

Having a criminal record will not necessarily bar you from working with us. If you declare any offences, we will ensure that an open and measured discussion takes place with the candidate and that two countersignatories (one of whom will usually be the HR manager) takes place on the subject of any offences or other matter that might be relevant to the position, before a decision is made regarding an offer of employment. This decision will depend on the nature of the position and the circumstances and background of your offences. Notes of the discussion and the outcome will be filed with the disclosure and destroyed when appropriate.

We make every subject of a DBS Disclosure aware of the existence of the Code of Practice. Copies are available from the Gov.co.uk website.

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HR form 1e