Personal Details :


Education :


Relevant qualifications E.G School/College/University/Adult Education/VQ/Assessors :


Work Experience :


Current Employment :


Previous Employment :


Passport Details :


Next of Kin:


References:



PROTECTION OF CHILDREN AND VULNERABLE ADULTS DECLARATION

Has any Social Service Department or Police Service ever conducted an enquiry or investigation into any allegations or that you may pose an actual or potential risk to children or vulnerable adults?
YesNo
Have you ever been convicted of any offence relating to children or vulnerable adults?
YesNo
Have you ever been the subject of any disciplinary procedure or been asked to leave employment or voluntary activity due to inappropriate behaviour towards a child or vulnerable adult?
YesNo

PROTECTION OF CHILDREN AND VULNERABLE ADULTS DECLARATION

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Applicants are therefore not entitled to withhold information about convictions, which for other purposes are spent under the provisions of the act and in the event of employment any failure to disclose such convictions could result in dismissal or disciplinary action by the employer. All Successful candidates will be required to obtain an enhanced disclosure report from the Disclosure and Barring Service. Have you ever been convicted of a criminal offence, or been subject to any confidential discharge, bind-overs or cautions.
YesNo

DECLARATION

I confirm that the information given within this form is true and accurate. I hereby give consent for this information being used for personnel administration and business purposes.