Employment application form

Position applied for: Location:

Job title

Vacancy ID

Where did you see this post advertised?

Personal details:
First Name Surname

Email address Telephone No.

Are you legally entitled to work indefinitely in the Tick box:

UK? Yes No
If your answer is no, please give details of your employment status:

Qualifications (most recent first)

Qualification and grade Date achieved Where it was achieved
(GCSE, NVQ, Degree etc)

Please provide details of any qualifications you are working towards.

Training
Please give details of any relevant training you have received.
Employment History

Employer Job Title Brief description of role Reason for leaving From To
- -/- -/- - - -/- -/- -

Please give details of any gaps in your Employment History

Personal Statement
Please explain how you fulfil each of the points on the Person Specification in the order they appear. If you
wish, please add additional numbered sheets after this page up to a maximum of 4 typed A4 sides, or the hand
written equivalent.

References
Following successful interview, you will be asked to provide contact details for referees who can comment on
your suitability for employment.
You will be asked to provide details for references that cover the past 36 months with no gaps, including from
any employment you have undertaken in that period. One reference must be from your current or most recent
employer. If you have not been employed for all of the last three years, you can provide details for a character
reference. Character references cannot be from friends or family members, but must be from someone you
know in a professional capacity such as an ex-colleague, tutor or community leader.

Recruitment of ex-offenders and DBS disclosures

Family Action complies fully with the DBS Code of Practice and undertakes to treat all applicants for positions
fairly. Family Action undertakes not to discriminate unfairly against any person subject to a Disclosure on the
basis of conviction or other information revealed.

A Disclosure is only requested after a thorough risk assessment has indicated that one is both proportionate and
relevant to the position concerned. For those positions where a Disclosure is required, all application forms, job
adverts and recruitment packs will contain a statement that a Disclosure will be requested in the event of the
individual being offered the position.

Family Action will ensure that every applicant who is subject to a DBS Disclosure is made aware of the
existence of the DBS Code of Practice, a copy of which will be made available on request.

Family Action undertakes to discuss any matter revealed in a Disclosure with the person seeking the position
before considering the withdrawal of a conditional offer of employment.

Family Action wishes to assure all applicants subject to a DBS Disclosure that having a criminal record will not
necessarily prevent them from being employed by us. Any decision to employ will depend on the nature of the
position and the circumstances and background of any disclosures listed.

If the role you are applying for requires a DBS check, please complete the declaration and agreement below. If
the role you are applying for does not require a DBS check please skip this question:
Do you have any unspent convictions, cautions, reprimands or warnings? Are you currently subject to criminal
investigations or procedures?

Yes No

Where a Disclosure is to form part of the recruitment process, Family Action encourages all applicants called
for interview to provide details of their criminal record prior to attending interview. Family Action requests that
this information is sent under separate, confidential cover to the Head of Human Resources via
[email protected] and we guarantee that this information will only be seen by those who need to
see it as part of the recruitment process.

Unless the nature of the position allows Family Action to ask questions about your entire criminal record we
only ask about “unspent” convictions as defined in the Rehabilitation of Offenders Act 1974.

Family Action will ensure that those in Family Action who are involved in assessing the relevance of a
conviction, caution, reprimand or warning to a post have the skills and knowledge to do so. Family Action will
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.

Family Action will 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 about criminal convictions or
other relevant non-conviction information immediately following a conditional offer of employment will
normally lead to withdrawal of that offer.

If there are significant discrepancies between the information declared and the information on the Disclosure
received, it will be necessary for Family Action to consider whether or not to withdraw a conditional offer of
employment. We will discuss any matter revealed with the candidate prior to making a final decision.
Guaranteed Interview Scheme

Family Action is committed to the employment and development of people with disabilities. As part of this
commitment we operate a Guaranteed Interview Scheme for applicants with disabilities who meet the
minimum criteria for the role.

If you have a disability and would like to apply under the Guaranteed Interview Scheme described above,
please tick here

Please specify if there is anything we need to know about your disability or if there are any reasonable
adjustments we can make in the recruitment process in order to offer you a fair selection process.

Equality & Diversity Monitoring Form

Family Action is committed to recruiting, retaining and developing a workforce that reflects diversity at all
grades. It is vital that we monitor and analyse diversity information so that we can ensure our processes are fair,
transparent, promote equality of opportunity and do not have an adverse impact on any particular group.

Please therefore complete the Equality & Diversity Monitoring survey found under the ‘Vacancies’ section of our
website or it can be accessed by clicking here.

Equality & Diversity data will not impact your application as all data will remain confidential, kept separate from
your application and not shared with the recruiting manager.

Declaration of relationships with Family Action employees

In order to mitigate against any potential conflicts of interest, we ask that you declare the existence of any close
personal relationships with persons whom you know to be employed by Family Action. This includes all familial
relationships, friendships, current or former romantic partners, and any person living at the same address as
yourself. This is not an exhaustive list and you should use your judgement to determine whether other personal
relationships could reasonably be perceived as a potential conflict of interest.

Please specify the name and nature of relationship of any person(s) employed by Family Action that you have a
close personal relationship with:

Declaration

Returning this form to Family Action via email acts as your ‘email signature’ and signifies your agreement to the
declaration below. Please save this form using your name as the file name and send to the email address stated in
the job advert.

Declaration

I confirm that the information I have given on this application form is a full and accurate record. I understand that
the information will form part of any subsequent contract of employment and, if it is found to be false, I may be
dismissed.

Signed Date