V1.
Specialist Support Work Application Form
Please ensure that you complete ‘ALL RELEVANT FIELDS’ as incomplete forms cannot be accepted. Submitting an
Incomplete form will delay your application being processed and may result in your application being rejected.
If you run out of space answering any questions, please use the additional information section at the end of this
application form.
How did you hear about this vacancy?
1. Personal Details
Title Surname Forename(s)
Prefer to be known by Previous surnames(s) (if applicable)
Address Postcode
Contact Number(s) Home: Mobile:
Email Address
Languages spoken
Date of Birth
Do you have a full UK Driving Licence? Do you have access to a car?
Do you currently have business insurance?*
Would you be willing to use your car to take out the children you support during sessions?*
Do you have any driving convictions? *
If you answered ‘yes’ to having any driving convictions , please can you provide details below*
* Proof of valid business insurance will be required before being eligible to take out a child in your own car
UK National Insurance Number
Have you been out of the country for longer
than 6 months in the past 10 years?
Are you a UK/EC/EEU National?
If you have answered ‘No’ and are legally entitled to work in the UK, please answer the questions below
What is the expiry date of your current Visa?
Does your Visa have any restrictions regarding employment in the UK?
Please supply details of any restrictions
(If applicable)
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Please note: Your eligibility to work in the UK will be subject to checking prior to assessment. If you are unable to provide
documents to support this, we will not be able to take your application any further.
2. Supporting Information
Please refer to the job description and think about transferable skills from previous employment, volunteer work, work
experience and/or any training that you may have undertaken that would benefit you in this role when answering the
questions below.
Please tell us why you are interested in applying for this role?
Please tell us about your experience working with children, especially those with special needs, or
vulnerable people (including voluntary and unpaid work)
What skills and knowledge do you have, and believe are required, to ensure the safety and wellbeing of
a vulnerable child?
How do you build effective relationships with others?
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2.1 Additional Supporting Information
To provide a beneficial support service to meet the needs of our young people, and their families, we need to be as flexible
as we can. We provide support to our families every day during the week, mainly after school, and weekends.
Sessions mostly take place between 4 and 8pm on weekdays and 10-1pm or 2-5pm at weekends. There are some sessions
during the day on weekdays but not many, so all support workers must be able to work some weekday evenings and/or
weekends.
Do you have any regular commitments Monday-Sunday when you would be unavailable to
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work? Please let us know what these are.
*If there are only certain weekend days that you can work during each month, please tell us below
3. Referees
Please provide details of two referees below who we can request a reference from. *
Please ensure you provide at least one employer reference, from your most recent employer. If you have not
had two previous employers, please supply details of a teacher or tutor you studied under during your
current/most recent education or from any volunteer work if applicable.
Please note – Unless you advise otherwise, referees may be contacted following your acceptance of an invite to
assessment.* We cannot accept references from colleagues, friends or family members, nor can we accept
personal email addresses for any referees.
Employer Name
Employer
Postcode
Address
Referee Name
Your Job Title Relation to you (e.g. Team Leader)
Contact Details(s) Business Phone: Business Email:
Can this referee be contacted prior to assessment?
Reference Type (please select by marking with an ‘x’) Employer Academic
Employer Name
Employer
Postcode
Address
Referee Name
Your Job Title Relation to you (e.g. Team Leader)
Contact Details(s) Business Phone: Business Email:
Can this referee be contacted prior to assessment?
Reference Type (please select by marking with an ‘x’) Employer Academic
4. The Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment)
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IMPORTANT INFORMATION
The Criminal Records Bureau (CRB) and the Independent Safeguarding Authority (ISA) have merged into the Disclosure and
Barring Service (DBS). CRB checks are now called DBS checks.
The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are now 'protected'
and are not subject to disclosure to employers and cannot be taken into account.
All cautions and convictions for specified serious violent and sexual offences, and other specified offences of relevance, for
posts concerned with safeguarding children and vulnerable adults will remain subject to disclosure. In addition, the
legislation covers equivalent offences committed overseas.
All convictions resulting in a custodial sentence, whether or not suspended, will remain subject to disclosure, as will all
convictions where an individual has more than one conviction recorded
As this role involves caring for, supervising or being in sole charge of children, we require you to undergo an enhanced DBS
check which is to be completed and assessed before working with our families.
If you are unsure about what you need to declare, please follow the link below to view the DBS list of offences that are ‘not
protected’ when conducting a criminal record check.
[Link]
record-check
Do you have any convictions, cautions, reprimands or final warnings that are not
"protected" as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975
(as amended in 2013)?
If you answered ‘Yes’, please provides details below of the nature of the order(s) and/or offence(s), any
penalties or sentence(s) received and the date(s) and place(s) of related court hearings.
Are you already enhanced DBS checked?*
If you have answered ‘Yes’, please provide the date this was completed* (dd/mm/yy)
Are you on the DBS update service?
Are there any dates where you will be unavailable to work (holiday or being away
from Manchester)?
*If you have already had an Enhanced DBS check previously, please bring it with you to interview.
Data Protection
The personal information that you have submitted in this form is for the sole use of the recruitment process, in
line with the Data Protection Act. If your application is successful and you are offered a position, it will also be
included with your employment records. If you are unsuccessful, it will be held on file for a period of 6 months
before being securely destroyed.
Declaration
I declare that, to the best of my knowledge, the information I am submitting in this form is true, factual and
accurate. I agree that if I have provided false, or intentionally omitted relevant and/or significant, information, it
may result in my application being rejected or, if already undertaking the role, dismissal.
I understand the declaration above
Full name Date
Please return your competed application form to recruitment@[Link] within 7 days of
receipt.
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