Application Form

SECTION B: Working Time Regulations 

You are not required to work more than an average of 48 hours per week. Only tick Yes to the following statement if you wish to be able to work more than 48 hours per week. 

SECTION C: QUALIFICATIONS / TRAINING 

SECTION D: EMPLOYMENT HISTORY 

Present and previous employment, including voluntary work for the last 10 years in reverse date order. 

SECTION E: Professional References 

Name, address and contact details of 2 professional referees, one of which must be your present or last employer/line manager 

SECTION F: Disability Discrimination Act 1995 

This information will not be used in the short listing process. If you have a disability according to the Disability Discrimination Act 1995, please give details. If you fulfill the criteria for the post, you will be given an interview. It will only be used in the interview process to assess whether any adjustment would be needed for you to carry out work for the post.

SECTION G: Moving & Handling Declaration 

SECTION H: Mandatory Training

COURSE

DATE

Basic Life Support / CPR

H&S, COSHH, RIDDOR

H&S, COSHH, RIDDOR

Infection Control

First Aid

Food Hygiene

Basic Fire Awareness

Lone Worker

Violence & Aggression

POVA

Manual Handling

SECTION I: Rehabilitation of Offenders Act 1974

Because of the nature of work for which you are applying, this post is exempt from the Provisions of Section 4.2 of the Rehabilitation of Offenders Act 1974 (Exemption Order 1975.) Applicants are therefore not entitled to withhold information about convictions which for other r 

Purposes are spent' under the provisions of the Act and in the event of employment any failure to disclose such convictions could result in the dismissal or disciplinary action by the employer. Any information given will be considered only in relation to this application.

DECLARATION

EQUAL OPPORTUNITIES MONITORING

ETHNIC ORIGIN