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JOB APPLICATION FORMPlease return to: HR Shared Services Team, Longhurst Group, Leverett House, Gilbert Drive, Endeavour Park, Boston, Lincolnshire, PE21 7TQ. Email: [email protected]
PLEASE USE BLACK INK OR TYPE Application Number: (For Office Use Only) __________________
JOB DETAILSJob Title: ___________________________________________________________________
Job Reference Number: ___________________________ Location: ____________________
How did you hear about this vacancy? Our Website Job Centre Word of Mouth
Newspaper Professional Journal Internal Bulletin Other
If you selected “Newspaper”, “Professional Journal”, or “Other”, please specify details below:
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PERSONAL DETAILSPreferred Title (please indicate by placing an X in the correct box)
Mr Mrs Miss Ms Other (please specify)______________
First Name(s): ___________________________ Last Name: ______________________
National Insurance Number: ______/______/______/_____/______
Address: __________________________________________________________________
_________________________________________ Post Code: _______________
Telephone Number (Day) _______________ Telephone Number (Evening) _______________
Mobile Number_____________________ Email: _____________________________________
RIGHT TO WORK IN THE UKDo you have any restrictions to working in the UK? (please indicate by placing an X in the correct box)
YES NO
If “Yes”, do you have the required authorisation to do the job you are applying for? YES NO
If “Yes”, please give details of your permit/VISA: ______________________________________
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If “Yes”, please state your permit/VISA expiry date: DD / MM / YYYY
EQUAL OPPORTUNITIESFriendship is an equal opportunities employer and we encourage applications from all sections of the community. Every person seeking employment will be considered on their merits and abilities to meet the specific needs of the job. We are required to report to our Regulators and Boards on this subject for monitoring purposes. Under the terms of the Data Protection Act 1998, this information will only be used to monitor our compliance with the law. Information collated below will be treated as strictly confidential and will be removed by Human Resources prior to being processed for short-listing. If you do not wish to answer this questionnaire, your application will not be affected in any way.
ETHNICITY (Please place a X in the box which best describes your ethnic origin)
White: British Asian/Asian British: Indian White: Irish Asian/Asian British: Pakistani White: Other Asian/Asian British: Bangladeshi Mixed: White & Black Caribbean Asian/Asian British: Other Mixed: White & Black African Black/ Black British: Caribbean Mixed: White & Asian Black/Black British: African Mixed: Other Black/Black British: Other Chinese Other
GENDER AGE
Male Under 21 41-50 Female 21-30 51-60 Transgender 31-40 61 and over
SEXUAL ORIENTATION RELIGION
Heterosexual Christian Buddhist Lesbian Roman Catholic Jewish Gay Jehovah Witness Hindu Bisexual No Religion Muslim Prefer not to state Other Religion Sikh
If “Other”, please state Religion:………………….
CRIMINAL CONVICTIONS 2
(Please read the guidance notes “Policy statement on the recruitment and rehabilitation of exoffenders” and “Guide to completing our application form point 4” before completing this section)
PLEASE COMPLETE ONLY FOR POSITIONS WITHIN CARE & SUPPORT:
These posts are subject to an Enhanced DBS (Disclosure & Barring Services) Disclosure.
An enhanced Disclosure is applicable for those applying for positions involving regular care and support of vulnerable adults and/or children. Under the Rehabilitation of Offenders Act 1974 (Exemptions Order 1975), you are also required to declare any warnings, motoring offences, cautions, convictions, or custodial sentences, regardless of the length of time that has elapsed since being received. Failure to do so may render you liable to summary dismissal.
Do you, or have you ever had any warnings, motoring offences, cautions, convictions, or custodial sentences? (Please indicate by placing an X in the correct box) YES NO
If “Yes”, please provide details of all to include dates and any outcome:
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DISABILITYFriendship is committed to the employment of disabled people and as such has been awarded the "Two Ticks" disability symbol. Under this scheme we are taking on five commitments to support recruitment, training and career development of disabled people. We will offer an interview to anyone with a disability whose application meets the minimum criteria for the job.
If you believe you have a disability i.e. a mental or physical impairment which has a substantial and long term effect on your ability to carry out normal day to day activities, and wish to be considered under the "Two Ticks" scheme, please tick the box below.
YES NO
Do you require any adjustments for an interview or written test? YES NO
If you require adjustments please provide details below:
___________________________________________________________________________
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DECLARATIONS OF INTERESTAre you related to a Friendship Board Member, tenant, or employee? (Please indicate by placing an X in the correct box)
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YES NO If Yes, please provide details. Name: _____________________________
Their Position: _________________________ Relationship to you: ____________________
Do you live in accommodation provided by Friendship? YES NO
If Yes, please provide details of address: ___________________________________________________________________________
REFERENCESFor external applicants we require references covering the past 3 years’ employment history, one of which must be from your current or previous employer. If you have worked with children or vulnerable adults for a period of three months or more, this must be one referee. If this is your first job and you do not have any employment or work experience history, or you are currently unemployed, then two professional character references from college principles, tutors or someone in a position of authority who knows you well will be acceptable.
For internal applicants, we require one reference from your current role within the organisation.
(Please read the guidance notes before completing this section)
If you do not complete this form it may delay the recruitment process.
Referee 1: Business Personal
Title: ______________ First Name: ________________ Last Name: ___________________
Relationship to you: ________________________ Job Title: __________________________
Organisation Name: ____________________________________
Organisation Address: _________________________________________________________
_________________________________________________ Post Code: ________________
Contact Number: _____________________ Email: __________________________________
Referee 2: Business Personal
Title: ______________ First Name: ________________ Last Name: ___________________
Relationship to you: ________________________ Job Title: __________________________
Organisation Name: ____________________________________
Organisation Address: _________________________________________________________
_________________________________________________ Post Code: ________________
Contact Number: _____________________ Email: __________________________________
Application Number (For Office Use Only): __________________
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QUALIFICATIONSPlease detail any qualifications achieved, starting with the most recent first. If you require more space, please continue on a separate sheet headed with your initials and job reference on top, and attach to/ enclose with your application.
If you are offered a post with Friendship, you will be required to show proof of the qualification(s) listed that are relevant to your position.
Name of Qualification Date Achieved Level/Grade University/ College/ School attended
TRAININGPlease detail any courses, seminars or in-house training attended, starting with the most recent first. If you require more space, please continue on a separate sheet headed with your initials and job reference on top, and attach to/ enclose with your application.
Course Title Date Attended
Company/Organisation/Institute Name
MEMBERSHIP OF PROFESSIONAL BODIESMembership Title and
LevelDate of Joining Membership No.
& Renewal DateName of Professional
Body/Institute
EMPLOYMENT HISTORY
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Please detail your last 10 years’ employment history starting with your current/most recent employment first and any previous employment in most recent date order. If you do not have any employment history, please complete the next section “Voluntary/Work Experience” instead. If you require more space, please continue on a separate sheet headed with your initials and job reference on top, and attach to/ enclose with your application.
Please do not enclose a CV as it will be removed before short-listing takes place.
PRESENT/ MOST RECENT EMPLOYMENT
Company/Organisation Name: __________________________________________________
Company/Organisation Address: _________________________________________________
________________________________________________ Post Code: __________________
Position Held: ________________________________________________________________
Date From: / / Date To: : / /____
Salary: £______________ per annum/ per hour/ per week/ per month (please delete accordingly)
Notice Period: _______________________
Why do you wish to change your current employment?
____________________________________________________________________________
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Description of main responsibilities/duties:
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PREVIOUS EMPLOYMENT
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Date Employed From
Date Employed To
Name of Employer Job TitleMain Responsibilities / Duties
Reason for Leaving
Are there any gaps in your employment history? YES NO If “Yes”, please provide details including reasons for these: _____________________________
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VOLUNTARY/ WORK EXPERIENCEPlease provide details of any voluntary/ work experience (including positions of responsibility). If you require more space, please continue on a separate sheet headed with your initials and job reference on top, and attach to/ enclose with your application.
Date From
Date To Name of Company/ Organisation
Position of ResponsibilityMain Responsibilities / Duties
Reason for Leaving
If you are offered a job by Friendship, do you intend to also work elsewhere? YES NO
CAR/ DRIVING LICENCE
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Do you have a full driving licence? YES NO
If “Yes”, do you have access to a car? YES NO
SUPPORTING INFORMATIONThis section should be completed by all applicants. Please provide further information below to support your application. We need to know how you meet our person specification and competencies, as well as details of your experience and skills that meet the job description and requirements of the job.
If you do not complete this section of the form, your application will be considered incomplete and will not be processed for short-listing.
Please continue on a separate sheet if necessary headed with your initials and job reference on top, and attach to/ enclose with your application. (As a guideline, upto 2 sides of A4 is sufficient).
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DATA PROTECTION ACT 19888
In relation to the Data Protection Act 1988, we ask you to provide certain personal data on the application form. This information is used for statistical purposes only, in relation to equal opportunity monitoring, best practice and the law. Longhurst Group conforms to requirements under the Data Protection Act and all unsuccessful applications are confidentially stored and destroyed after 6 months.
DECLARATIONI confirm that the information given in this application is true and accurate to the best of my knowledge. I understand that any information I have provided which is later found to be a false statement could result in my employment being terminated without notice should I be successful.
I also understand that any offer of employment made to me is subject to 2 satisfactory references and a satisfactory DBS disclosure (if required for the role). I am aware that my offer could be withdrawn if either are unsatisfactory to the organisation.
I note that Friendship conforms to requirements under the Data Protection Act 1998 and that you may hold information in this application form on manual and computerised files for relevant employment related purposes. I also understand that all unsuccessful applications are confidentially destroyed after 6 months.
If you are completing this form electronically, you are required to enter your name and date of your application to confirm that the information you have given is true and accurate.
Signature: ________________________________ Date: __________________
Longhurst Group9
Friendship Care and Housing joined the Longhurst Group in April 2006.
The Longhurst Group is the parent company of a dynamic group of housing service companies. It is an ethical business driven by a passion to make a difference to people and communities.
Longhurst Group has more than 18,000 homes across the Midlands and East of England and has a healthy development programme underway to create high quality new homes. More than that, a full spectrum of personal support is provided – from debt advice to specialist dementia care – for thousands of people in need.
Friendship share resources and expertise within the Longhurst Group and our Chair of the Board and Managing Director sit on the Group Board. Our Managing Director is also a member of the Group Executive Team.
A structure chart showing all members is shown below:
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