Post applied for Full Name Address Home Telephone Number Mobile Number
Email How did you hear about this post? If you heard about the post online, please indicate which website? How much notice do you have to give your present employer? What date are you available to commence employment?
Do you have the right to work in the UK? (You will be asked to provide evidence) YesNo
Are you related to any staff or committee members of the Association? YesNo
If yes please give brief details
Have you applied for a post at Rockdale before? YesNo
If yes, for which post?
If yes, date of the application that you made before?
Please list your education from age 11
School/College & dates attended
Examinations Passed
Please give details of any further qualifications obtained and provide copies of relevant certificates
Please give details of any further relevant courses attended
Are you registered with, or have membership of, any professional body? YesNo
Please give details and provide evidence
Start with your present or most recent job. If you are applying for a care post at Rockdale please give your full employment history listing all your previous employers
Name and address of present employer
From
To
Position held and responsibilities
Reason for leaving
Salary (GBP)
Name and address of previous employer
Please give the details of two work related referees, including your current or most recent post. If you cannot provide two work related references then the second reference should be from someone who has known you at least five years and is not a member of your family.
If you are applying for a care job, ideally one reference should also relate to your last period of employment of not less than three months duration involving work with vulnerable adults. Work related referees should be able to comment on your ability to meet the demands of the post for which you are applying and also confirm your reason for leaving that employment. Referees will not be contacted without your prior consent. Please indicate on the form whether the referees you have given will be expecting a request for a reference
Name Occupation Address Email address Telephone Number In what context do you know this referee? Does your referee know you have given them as a reference? YesNo Would your referee prefer to be contacted by post or email? PostEmail May we take up this reference before any offer of employment is made? YesNo
Do you give your consent for the Association to approach the above for references? YesNo
Signature (type name)
Please give any other information which you think may assist your application. In particular, outline the skills, experience and abilities you have which you think are relevant to the post for which you are applying, and make you suitable for the position (please continue on another page if necessary)
As Rockdale Housing Association meets the requirements in respect of exempted questions under the Rehabilitation of Offenders Act 1974, applicants who are offered employment in certain posts will be subject to a criminal record check from the DBS before the appointment is confirmed. This will include details of cautions, reprimands or final warnings, as well as convictions. This check may also include reference to the DBS Adults Barred List. A criminal record will not necessarily be a bar to obtaining employment with the Association, but inclusion on the DBS Adult Barred List will. Our procedures will be carried out in the strictest confidence and in accordance with the Disclosure and Barring Service Code of Practice. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’, are not subject to disclosure to employers, and cannot be taken into account.
Do you have any past or pending cautions or convictions not protected as above? YesNo
If Yes please give brief details which will be kept confidential
We are an equal opportunities employer and welcome applications from all sections of the community. Under the Equality Act 2010 we are asking the following questions to ensure we can facilitate any applicants who may have a disability within the meaning of the Act. Information provided will be kept confidential.
If you are registered disabled are there any special adaptations, we may need to consider regarding either an interview or the work required in the post? YesNo
If Yes please give details
Rockdale Housing Association complies with the General Data Protection Regulations. We will only use the information provided on this form as part of our recruitment and personnel procedures. If your application for employment is unsuccessful (including when you have speculatively applied to us in respect of a role which is not available), we will hold your data on file for 6 months. At the end of that period, your data is deleted or destroyed (unless we need to retain it for longer to exercise or defend any legal claims). If your application for employment is successful, personal data gathered during the recruitment process will be transferred to your personnel file and retained during your employment. The periods for which employee data is held will be provided to you in a separate privacy notice. We will not pass any data to a third party and you have the right to say that you do not want us to hold onto your data.
I agree to the personal information provided on this form being used as described above.
I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect will be sufficient cause to cancel further consideration of this application, or immediate termination of employment.
Signed
Date
