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Details of Post Applied For:
Job Title
Job Reference Number (if any)
Confirm date you would be available to start work, if successful
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Have you been referred by a friend who currently works at Prosperity? If so, please provide their name here:
Personal Details:
Select
Mr
Mrs
Ms
Other
First Name(s)
Surname
Date of Birth
The Governing Body complies with the Equality Act 20210 and does not discriminate against job applicants on the grounds of age. Date of birth and other key dates are requested of applicants for identification purposes and to varify that a full education and employment history has been provided, in accordance with statutory guidance from the DfE ("Keeping Children Safe in Education").
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If you have previously been known by another name, please specify:
Street Address
Town
County
Postal Code
Daytime Contact Number
Evening Contact Number
Mobile Number (if different)
Email Address
National Insurance Number
Do you currently have the right to work in the UK?
Yes
No
If no, please specify your circumstances:
Education & Qualifications
Please also include any relevant professional qualifications:
Name of Institution
From (Day/Month/Year)
Day
Month
Year
To (Day/Month/Year)
Day
Month
Year
Courses/Subjects Taken and Examination Results or Award
Professional Development
Please give details of any courses undertaken which you have not detailed above and which you consider to be relevant to this application.
Course Title
Course Provider
From (Day/Month/Year)
Day
Month
Year
To (Day/Month/Year)
Day
Month
Year
Award (if any)
Membership of Professional Bodies:
Please give details of any relevant professional bodies to which you belong:
Name of Professional Body
Membership Status
Date Membership Commenced
Driving Licence:
Do you hold a current Full Driving Licence?
Yes
No
Do you have any current endorsements?
No
Yes
If yes, please provide details:
Employment History
Please give details of all periods of employment you have undertaken. List the information in reverse chronological order (i.e with your current or most recent position first). Any gaps in your employment and/or training and education history will be explored with you if you are called for interview.
Employer's Name and Address
Employed From
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Employed To
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Position Held
Salary and Benefits
GBP
Reason for Leaving
Periods When Not Working
Please give details below of any voluntary work you have not detailed above, or reasons for other periods of time when you have not been employed since leaving secondary education
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To
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Reason
Statement of Application
You are invited to provide further information in support of your application. Please make full use of this section and continue on additional sheets if necessary. Please refer to the person specification for the post and also include: • The reasons why you are applying for this post; • The personal qualities and experience that you feel are relevant to your suitability for the post; • Key responsibilities and achievements in your present or most recent job which are relevant to this application; • Details of any relevant interests or activities.
Text
Referees:
References will only be sought for successful candidates. It is our policy to obtain references prior to you commencing your role with us. If you have concerns regarding this, please contact us. • The first referee provided must be your present or most recent employer, unless you have not been in employment before. If you are not currently working with children but have done so in the past, your second referee must be that employer. • Any other referees must be your previous employers or if applicable must be obtained from your prior education (e.g. a college or university lecturer). • If any of your references relate to your employment at a school or college your referee must be the Headteacher or Principal. • Your referees will be asked about any disciplinary offences/investigations and safeguarding allegations/concerns. • Please do not name relatives or people acting solely in their capacity as friends as referees. • You must provide reference details for the previous 5 years. • Other previous employers may also be approached for information, prior to employment, to verify details on your application form, such as particular experience or qualifications.
First Name
Surname
Occupation
Tel. Number
Email Address
In what capacity do you know the referee?
Reasonable Adjustments to the Shortlisting Process:
Prosperity Children’s Services welcomes applications from disabled people. Please indicate in the box below if there is anything that we need to do, or take into consideration, to ensure that the shortlisting process is fair in relation to a disability.Candidates who are invited for interview will be asked in the invitation letter if they require any adjustments to be made to the interview or other selection activities.
Declarations
This post is exempt from the Rehabilitation of Offenders Act 1974. If you are appointed you will be required to undertake an Enhanced Disclosure & Barring Service (DBS) check (previously known as a CRB check). You are required to declare any unspent convictions, cautions, warnings and bind-overs you may have, regardless of how long ago they occurred, as well as any pending criminal proceedings or current police investigations. Having a criminal record will not necessarily prevent you from taking up appointment; this will depend on the nature of the offence(s) and their relevance to the post you are applying for. However, should you not declare any of the above and this is subsequently revealed, e.g. through the DBS check, then this may place your appointment in jeopardy. Important changes to the law on the disclosure of criminal records information mean that a prospective employer can only ask you to disclose any unspent cautions, convictions, warnings or bindovers, that are not "protected" under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). New filtering rules have also been introduced, although these rules do not apply for individuals who have two or more convictions. Guidance and criteria on the filtering rules can be found at the Disclosure and Barring Service website at: https://www.gov.uk/government/publications/filtering-rules-for-criminal-record-check-certificates. Also, because positions in working with children are considered to be ‘excepted’, when your certificate is issued it may contain information on spent convictions that the DBS decides your employer needs to take into account in order to ensure the protection of vulnerable groups, including children. In addition, some specific offences will never be removed from a DBS certificate, such as serious sexual and violent offences. You can view this specified list of offences at: https://www.gov.uk/government/publications/dbs-list-of-offences-that-will-never-be-filtered-from-a-criminal-record check. Further guidance on what convictions you must declare and a policy on recruiting ex-offenders are available from the HR.
Do you have any unspent convictions, cautions, warnings or bind-overs that are not "protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) and/or are you the subject of a current police investigation or have criminal proceedings pending against you?
No
Yes
Are you on the Children’s Barred List (previously List 99 and PoCA list) or have you ever been disqualified from working with children or been subject to any sanctions imposed by a regulatory body (e.g. General Teaching Council, Teaching Agency)?
No
Yes
It is a criminal offence for barred individuals to seek, or to undertake, work with children. If you have answered ‘YES’ to either of the above, please provide further details on a separate sheet in a sealed envelope marked ‘CONFIDENTIAL’.
Are you registered with the DBS Update Service?
No
Yes
DBS Registration Number
Annual Registration Renewal Date
Level of check obtained at point of registration?
Standard
Enhanced
Which workforce was your check requested for at point of registration?
Children
Adult
Adult & Children
Other
Declaration: By signing this application form and providing the information above I understand that I am authorising Prosperity Children’s Services to consult the DBS Update Service in the context of its recruitment and safeguarding procedures and agree to provide the relevant disclosure certificate to facilitate this process.
A Note on Childcare Disqualification Requirements
In addition to undertaking checks to ensure that members of staff are suitable to work with children, children’s homes are also specifically required to establish that members of staff are not disqualified from working with children who have not yet reached the age of 8 in order to comply with the Childcare Act 2006 and the Childcare (Disqualification) Regulations 2009. All staff responsible for the provision or management of such childcare (including teaching) are therefore required to declare that they are not disqualified from undertaking such work upon appointment. A disqualified person is not permitted to provide or manage care for children under age 8 unless they apply for, and are granted, a waiver from Ofsted. In summary, a person may be disqualified through: • Inclusion on the Children’s Barred List; • Being cautioned for, or convicted of, certain violent and sexual criminal offences against children and adults; • Grounds relating to the care of children (including where an order is made in respect of a child under the person’s care); • Having registration refused or cancelled in relation to childcare or children’s homes or being disqualified from private fostering; • Living in the same household where another person who is disqualified lives or works (referred to as disqualification ‘by association’). Disqualification also applies to equivalent offences committed overseas. The Regulations do not automatically apply to all posts in settings where there is no provision for children under 8. You will therefore be informed if the Regulations are relevant to the post you are applying for. Should you need to, you can find out more about disqualification in the Department for Education’s guidance: https://www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006
Are you related to, or do you have a close personal relationship with, any elected member or senior officer of the local authority or a member of staff at Prosperity Children’s Service?
No
Yes
If yes, please provide below their name(s) and role(s), and state your relationship:
Disciplinary Issues
Have you ever been dismissed or resigned in the face of a dismissal or warning?
No
Yes
Have you ever been the subject of an allegation(s) in relation to the safety and welfare of children, young people and / or vulnerable adults, either substantiated or unsubstantiated?
No
Yes
Form Section
I declare that the information I have given on this form is correct. I understand that providing false or misleading information is an offence which could result in my application being rejected, or, in the event of employment being obtained, may result in disciplinary action being taken, up to and including summary dismissal. It could also result in a referral to the police. I understand that my application form will be retained on file for a period of six months (or transferred to my personnel file in the event that my application is successful) and give my consent for the personal data supplied to be used for the purposes of recruitment and selection.
Retention of Application Forms: The General Data Protection Regulation (GDPR) It is Prosperity Children’s Services policy to retain all application forms for unsuccessful applicants for a period of six months, after which time they are securely destroyed. If another suitable vacancy arises during that period which we think might suit your skills and experience, we may contact you to make you aware of the vacancy.
Radio
I do not wish for Prosperity to use my data in this application form in this way.
Submit
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