APPLICATION FOR EMPLOYMENT

Please complete this form either electronically or in black ink and return to the address below

Title of post applied for: Closing date:

58-60 Albert Street, Motherwell, North Lanarkshire, ML1 1PR

May we call you during the day? Yes No

Are you licensed to drive in the UK? Yes No

Do you have any endorsements on yourlicense? Yes No

If yes, please give details______________________________________________________________________

Would you be willing and able to use yourcar to transport customers if required? Yes No

Do you have a disability as recognized byThe DDA 1995? Yes No

If yes, are there any reasonable adjustment required for you to attend an interview?

___________________________________

Personal Details

Surname Forename

Title Preferred Name

Address

Postcode

Home Tel Number Mobile Number

National Insurance Number E-mail Address

The role you are applying for requires you to work flexibly are there restrictions on the work pattern or hours Yes No you would be able to work, e.g. weekends or evenings?

If yes please give details

Some of the people we work for are smokers,would you have any objections to working with someone Yes Nowho smokes?

Are you registered with the SSSC Yes No

If yes, what is your registration number _______________________________________

Are you a member of the Protection of VulnerableGroup Scheme? Yes No

All offers of employment are subject to successful registration into the Protection of Vulnerable Group Scheme. If you are already a member a Scheme Record Update is required costing £18. If you are not a member then full membership will be required costing £59.

If successful at interview SOL will supply the application form and act as countersignatures for both membership and updates, however the cost of these will have to meet by yourself, with half the cost required prior to submission of the form.

A mandate is attached at the end of the form, which will be applicable if successful.

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Education History – Please provide full details of your education and qualifications. You will be required to provide original certificates prior to starting work. Continue on a separate sheet if requiredName of Place Attended Subject(s)/ Course(s)

TakenDate(s) Attended Qualifications and Grade(s)

Achieved

Training History – Please provide full details of any relevant training that you have completed.. You will be required to provide original certificates prior to starting work. Continue on a separate sheet if requiredName of Place Attended Subject(s)/ Course(s) Taken Date(s) Attended

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Current EmploymentName and address of Employer

From To Job Title and description of your Job

Reason for Leaving

Notice Period: Salary:

Employment History (continue on a separate sheet if required)Name and address of Employer

From To Job Title and description of your Job

Reason for Leaving

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Breaks in Employment – Please use this space to explain any gaps you have in your employment history since leaving school, e.g. attending college

Please indicate your level of proficiency in the following

High Moderate Low No AbilitySpoken English

Reading

Writing

Understanding Instructions

Basic Arithmetic

Microsoft Word

Microsoft Excel

Microsoft Outlook

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Please describe what particular skills you have which lead you to believe you would be good at this job.

Please describe your understanding of this role.

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Which aspects of the role would you personally find most challenging

From the job description and person specification provided please give details of any training or further learning and development you may need to fully carry out the duties and responsibilities of this post.

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Gift PosterTo support the people we work for, to choose the people they want to work with them, they would like to get to know you a bit better. The people we work for want someone to work with them who they can get on with and share some hobbies and interests with. Please fill in the Gift poster below (there is an example on the next page if you need help filling this out) to tell us a bit more about yourself. You can use words, pictures or drawings to fill in the sections.

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Who am I? Hobbies, Interests and Passions

Gifts- These are personal traits that you have, for example making people feel at

ease, being easy to talk to

Talents – this is something you have learnt that you can teach others

If you have a successful interview, it will be necessary for us to take up two written references prior to your appointment. You should therefore provide the names of two people who know you well. One referee should be from your current or most recent employer. Please note we reserve the right, on occasion to take up additional references.

Referee 1 (Employer) Referee 2 (personal-not a relative)

Name: Name:

Address:

Postcode

Address:

PostcodeTelephone No.: Telephone No.:

E-Mail: E-Mail:

Job Title/Relationship Job Title/Relationship

Declaration

Read carefully and sign the declaration below. Before doing so please check you have completed: All pages of the employment Application Form.

I confirm that the information I have given is, to the best of my knowledge, complete and accurate and that false information, omissions or misleading statements may lead to any offer of employment being withdrawn or dismissal without notice.

I understand that, due to the nature of this post, I must be a member of the PVG Scheme, which will be sought in the event of a successful application.

I understand and agree that data contained in this application will be kept in accordance with the principles of the Data Protection Act 1998, it will be used and processed for recruitment purposes and that, if I become an employee, it will be used for employment purposes also.

Signature: ……………………………………………………………………………..

Date: …../…../…….

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CRIMINAL CONVICTIONS DECLARATION FORM:

Please provide full details of any convictions, charges or police enquiries together with dates and any penalty imposed.

PERSONAL INFORMATION: (Please complete using block capitals and blank ink)First Name: Surname: Date of Birth:

Date Please explain fully the nature of the conviction, charge or police enquiry

Penalty Imposed

Please continue using a separate sheet if necessary

Signature: ………………………………………. Date of signing: …………………………..

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EQUAL OPPORTUNITIES MONITORING FORMSupport for Ordinary Living is committed to equal opportunities in all of its

employment policies. The information you provide below will be treated as strictly confidential and will not form part of the selection process. Please complete this

questionnaire in order that we collect data to monitor the fairness of our recruitment selection decision. All data is strictly confidential and will not be seen by the

selection decision makers. The form must be completed and returned to Support for Ordinary Living in the envelope provided.

Post applied for: (please put full title of post)____________________________

Section 1: Gender

MaleFemalePrefer not to say

Section 2: Age 16-19 20-2930-39 40-4950-59 60+Prefer not to say

Section 3: Ethnic Group (background or culture)

White Scottish Other (South) AsianOther White British ChineseWhite Irish CaribbeanOther White AfricanIndian Black Scottish and other BlackPakistani MixedBangladeshi OtherPrefer not to say

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The Protecting Vulnerable Groups Scheme (PVG Scheme)

PVG Application

All successful applicants will require to have a membership of the PVG Scheme. Support for Ordinary Living uses this information only as one part of the organisation’s normal processes for checking suitability of candidates.

Successful applicants will be required to pay the current standard fee of £59 for their PVG Scheme membership/ £18 for their PVG Scheme record update. The cost will be paid by Support for Ordinary Living and deducted in instalments from the employee’s wages.

Please complete and sign the attached wages deduction mandate

PVG Mandate

Name of Employee

National Insurance Number

I authorise the following payroll deduction from my wages from Support for Ordinary Living, for

Payment for PVG Scheme membership application of £34

Payment for PVG Scheme record update of £9

Signatures

FOR OFFICE USE ONLYFull Payroll Reference Number

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Please Tick

Information / Guidance Notes

Please complete all sections of the application form, giving as much detail as possible.If you have any questions relating to the form, please contact us on 01698 276206 for clarification.

Gift PosterThe people we work for are included in all areas of our recruitment, to assist them to see what you can bring to the organisation, we use the gift poster.Please the see the example below.

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Data Protection

The Company requires certain information prior to you commencing employment, to ensure you will be able to perform the requirements of the job and give reliable service, and to ensure compliance with relevant Health and Safety regulations. The information is also required in order to establish whether any reasonable adjustments may need to be made to assist you in performing your duties, in accordance with the Disability Discrimination Act 1995 and Equality act 2010The information you provide will be treated in the strictest confidence, and used only for the purposes detailed above in compliance with the Data Protection Act 1998.

The Protecting Vulnerable Groups Scheme

Disclosure Scotland is responsible for issuing 3 levels of certificates. The aim of Disclosure Scotland service is to enhance public safety and to help employers and voluntary organisations in Scotland to make safer recruitment decisions. The Bureau will provide criminal history information on anyone seeking employment or voluntary posts, which involve positions of trust such as working with children or vulnerable adults. This service improves access to criminal records and other relevant information held by the police and by government departments and is available for people who need to prove whether or not they have any criminal convictions. During the recruitment process SOL will encourage applicants to disclose criminal records and any other related information at the interview stage to explore all relevant factors.All successful applicants with Support for Ordinary Living will are required to undergo a PVG/disclosure check. Support for Ordinary Living uses this information only as one part of our normal processes for checking suitability of candidate’s positions.

Equality and Diversity

Support for Ordinary Living is an equal opportunities employer and actively welcomes job applications from all sections of the community. No job applicant will be treated less favourably because of his or her gender, race, colour, ethnic origin, age marital status, disability, religion or belief, sexual orientation or by any other condition or requirement that cannot be shown to be justified.

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