Post: Hours: Unit/Location: Closing date for Applications: Where did you see this position advertised? APPLICATION FOR EMPLOYMENT (PLEASE TYPE OR USE BLACK INK) PERSONAL DETAILS Surname: Forenames: Title (Mr/Ms/Mrs/Miss etc): Address: Please note that CVs will not be considered Telephone (home): Postcode: Mobile phone number: Email Address: NI number: PVG Scheme membership number if applicable: Do you hold a current driving licence? Do you have any current endorsements? Do you own/have unlimited access to a car? YES / NO: YES / NO: YES / NO: If you are selected for interview, please choose a preferred way for us to contact you: Email / letter by post Are there any restrictions on you taking up employment in the UK? Please note that you will be required to provide proof that you can legally live and work in the UK (e.g. Visa, Work Permit, Residence Permit). Yes/NO If Yes, please give details: Are you related to anyone who is a current or former Employee, Board Member, Tenant of Barony? Yes/No If yes please give details: Have you previously been employed by Barony? Yes/No If yes please give details: 1
EDUCATIONAL QUALIFICATIONS - SCHOOL Please give details of educational qualifications passed/awarded. School Qualification Level and Subject Grades/ Date Awarded FURTHER EDUCATION INCLUDING VOCATIONAL QUALIFICATIONS Please give details of any further education qualifications and/or membership of professional bodies. Qualification Level and Subject College/Authority/University Level/Grades/ Date Awarded QUALIFICATIONS THAT YOU ARE CURRENTLY STUDYING FOR Qualification Level and Subject College/Authority/University Finishing date PROFESSIONAL REGISTRATIONS/MEMBERSHIPS Please give details of any clinical/ SSSC/professional registrations that you currently hold. Professional Body & Registration Status Registration/PIN Number Member since (date). If you are applying for a post that requires professional registration you are required to provide the following information: Are you currently the subject of a fitness to practice investigation or proceedings by a licensing or regulatory body in the UK or in any other country? Have you been removed from the register or have conditions been made on your registration by a fitness to practice committee or the licensing or regulatory body in the UK or in any other country? Yes / No Yes / No 2
EMPLOYMENT HISTORY- PRESENT OR MOST RECENT EMPLOYMENT Name and address of current or most recent employer Position held: From: To: Reason for leaving and salary: List of duties, responsibilities and achievements PREVIOUS EMPLOYMENT HISTORY Please give as much information as you can about your work/voluntary work history. If you have taken study/career breaks please include details. For guidance, information about unrelated positions dating back more than 15 years need not be provided. Employer s Name, Address and Postcode Position held: From: To: Reason for leaving: List of duties, responsibilities and achievements Employer s name and address and Postcode Position held: 3
From: To: Reason for leaving: List of duties, responsibilities and achievements Employer s name and address Position held: Postcode From: To: Reason for leaving: List of duties, responsibilities and achievements Employer s name and address Position held: Postcode From: To: Reason for leaving: List of duties, responsibilities and achievements Please give details of the dates and reasons for any breaks in your employment history PERSONAL STATEMENT 4
Please use this section to explain why you think you are suitable for the role. Refer to the job description and the person specification, which sets out the skills and experience required for the post. Explain how you meet these criteria by reference to your experience, achievements, qualifications and training (both inside and outside work). Short-listing will be based on how well you demonstrate your ability to meet the essential criteria. (You can continue on a separate sheet if necessary). 5
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REASONABLE ADJUSTMENTS Do you believe there to be any aspect of the post that will require adjustments to be made or additional support to allow you to undertake/complete the tasks? If so please provide details of any reasonable adjustments you would require. Please use a separate sheet if necessary. If you have a disability and meet the minimum requirements of the selection criteria for the post you will be guaranteed an interview. Do you wish to be considered under this scheme? Yes No REFEREES Please provide the name and address of two referees. The first should be your current or most recent employer and must be a line manager who can comment on your work performance, conduct and attendance. The second referee should be a previous employer. If this is your first job please give details of your Head Teacher or College Tutor, and/or, if you have carried out voluntary work, someone who can confirm the nature of the volunteer role. Name: Job Title: Organisation Name: Business Address: Name: Job Title: Organisation Name: Business Address: Tel No : Tel No : Business email address : Business email address : Contact referee now? YES/NO Contact referee now? YES/NO REHABILITATION OF OFFENDERS ACT Criminal Record As an organisation providing care services, employment with Barony is exempt from some of the Rehabilitation of Offenders Act 1974. This means that you will be required to undergo either a PVG check or Standard Disclosure dependent on the nature of the role. Such checks will result in disclosure of any unspent convictions to Barony and also some spent convictions as required under the Rehabilitation of Offenders Act 1974 (Exclusions and Exceptions)(Scotland) Amendment Order 2015. DECLARATION I acknowledge that any offer of employment with Barony is subject to satisfactory references, PVG check, health information provided and a medical examination (if required by our Occupational Health provider). 7
I confirm that the information supplied by me on this form is, to the best of my knowledge, true and complete. Any false statement may be sufficient cause for rejection of my application or, if employed, my dismissal from Barony. The information you provide on this form will only be used in accordance with the principles of the Data Protection Act 1998. If you are appointed, it will form the basis of your personal record held by Barony. Signature Date If you are sending your application form by email, please tick the box to indicate that the information provided on this form is true: Completed Application Forms should be sent to: Carol Kerr HR Co-ordinator Barony Canal Court 40 Craiglockhart Avenue Edinburgh EH14 1LT 8
EQUAL OPPORTUNITIES IN EMPLOYMENT POLICY - EQUALITY ACT 2010 We aim to be an equal of opportunity employer and we select staff solely on merit irrespective of race, sex, disability, etc. In order to monitor the effectiveness of our Equal Opportunities in Employment Policy, we request all applicants to provide the information requested. THIS FORM MUST BE RETURNED WITH YOUR APPLICATION FORM. THIS FORM IS REMOVED BEFORE SHORTLISTING AND WILL NOT BE SEEN BY THE SELECTION PANEL. Name: Date: Position applied for: Location: 1. Gender: Male Female 2. Date of birth: 3. Marital status: Married Single Divorced Other Please specify 4. Nationality: 5. How would you describe your ethnic origin? 1. White Scottish Other British Irish Gypsy/ Traveller Polish Any other white background 2. Mixed or Multiple Ethnic Background 3. Asian Indian Pakistani Bangladeshi Chinese Any other Asian Background 9
4. Black, Black Scottish or Black British Caribbean African Any other Black background 5. Other Ethnic backgrounds Arab, Arab Scottish or Arab British Any other group 6. Are you a person with a disability, as defined by the Disability Discrimination Act? Yes No 7. How would you describe your religion or belief? Christian Buddhist Hindu Jewish Muslim Sikh None Prefer not to say Other please specify 8. Which of the following describes your sexual orientation? Bi-sexual Gay Heterosexual Lesbian Other Prefer not to disclose Thank you for completing this form. Please return it with your application. 10