Safer Recruitment Application Form

Please ensure you complete all sections of this form and note C.V.s will not be accepted
Post applied for Reference

Personal Details
Title: Other: Last Name
First Name Known as
Any former names
Address

, Postcode
Preferred telephone number Email
How would you like us to contact you about your application? Email Post

Working in the UK
Are you eligible to work in the UK/EEA? Yes No
Do you require a work permit to work in the UK? Yes No
National Insurance Number Date of birth
ISA Registration Number:
Social Worker Registration Number:

Employment History
Starting with your most recent job, paid and/or unpaid, please list employment providing
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all of the details requested. It is important that you include periods of unemployment;
detailing which office you may have received benefits from, and if you have been self
employed you will need to provide proof.
If you are short-listed we will obtain references, which may cover a full three-year history,
they could include time spent in education. In addition to information on ability and
performance we will be seeking information on recent sickness.
Name of Current/Last Employer
Address
Postcode Employer’s telephone number
Job Title Salary
Date from Leaving date or notice period
Reason for leaving
Brief description of responsibilities:
Employment history cont.
Previous Employment
Employer’s/Organisation’s Name Salary
Address Post code
Post held Date from to
Reason for leaving

Employer’s/Organisation’s Name Salary

Address Post code
Post held Date from to
Reason for leaving

Employer’s/Organisation’s Name Salary

Address Post code
Post held Date from to
Reason for leaving

Employer’s/Organisation’s Name Salary

Address Post code
Post held Date from to
Reason for leaving
Please provide details of any gaps of employment history – with dates

Please tell us how many days you have been absent from work due to sickness in the last 2 years
Total days Number of occasions

Referees
Please give the details of two referees. One of these should be your Line manager with your present
and/or last employer. Please see guidance notes for more information.
Referees name Post held
Address
Postcode
Email address Telephone number
Your relationship to the referee

Referees name Post held

Address
Postcode
Email address Telephone number
Your relationship to the referee
Previously employed by London Borough of Redbridge
If you have been previously employed by the London Borough of Redbridge, please complete this
section
Post held Date from to
Location Line manager
Reason for leaving

Qualifications and training

Secondary Education
Name of school/college Date from to
Address
Post code
Qualifications and grades obtained
Pease give details of any qualifications or training that you have received, which support your
application. Include any on the job training as well as formal courses.
Name of College/University/Other Date from to
Address
Post code
Qualifications and grades obtained:

Name of College/University/Other Date from to

Address
Post code
Qualifications and grades obtained:

Professional Qualifications/Registrations (EG GSCC, DFES)

Please provide details of any professional qualifications & membership of professional institutes that
you hold
Name of professional body
Membership grade and number
Date Obtained

Name of professional body

Membership grade and number
Date Obtained

Name of professional body

Membership grade and number
Date Obtained
Supporting Statement and Achievements
Please use this space to tell us how you meet each of the points on the person specification – you will
find it useful to refer to the Guidance Notes to help you complete this part of the form. We need to
have this information in order to consider your application. Please attach additional information if
you require more space.
Disability
The Disability Discrimination Act protects people with disabilities from unlawful discrimination. To
meet the Act’s definition, a person must have a physical or mental impairment, which has substantial
long-term effects on their ability to carry out normal day-to-day activities. If we know you have a
disability we will make adjustments to the working arrangement and/or the working environment
provided it is reasonable in the circumstances to do so.
Do you have a disability you wish us to know about at this stage? Yes No
Please let us know what access requirements you have:

Declaration
.

Are you related to, or have a close personal relationship with, any councillor,
council employee or school governor for the school you are applying Yes No
If Yes, please state their name and the position they hold
Name Position held
Name Position held

Canvassing of employees or councillors directly or indirectly will disqualify candidates from

appointment.
Some posts are also subject to political restrictions under the provisions of the Local Government and
Housing Act 1989. If this post is subject to these conditions, further details will be made available to
you.
The Council must protect the public funds that it handles and so may use the information you have
supplied on this form to prevent and detect fraud. This may include matching the information on this
form with other information the Council holds on you from other sources, including data held on
computer records. The Council may also share this information, for the same purpose, with
government agencies that monitor public funds.
I will declare to the London Borough of Redbridge, if appointed, my intention to continue work for
another employer or on a self employed basis (under the Working Time Directive).

Data Protection
The Council intends to fulfil all its obligations under the Data Protection Act 1998 (the Act). The
Council will ensure that all processing of data falling within the Act is appropriately notified to the
Information Commissioner. Individuals whose information is held and processed by the Council can
be assured the information will be maintained in confidence and treated with all due care. The
Council tries to keep information held about you accurate and up-to-date. However, if you find any
inaccuracies you have the right to have them corrected.
I understand that providing misleading or false information/qualifications will disqualify me from
appointment or if appointed, may lead to disciplinary action and dismissal.
I authorise the London Borough of Redbridge to check the information supplied and hold all
such information in both paper and electronic formats.
If you are successful in your application you will be asked to sign this declaration.
Signature Print Name Date
 Workforce Monitoring

Application Ref No.

In line with the Codes of Practice issued by the Equal Opportunities Commission and the
Commission for Racial Equality and as required by the Audit Commission, Redbridge
Council collects and maintains information on gender, ethnic origin and disabilities of its
employees.

It will be appreciated if you will complete this section of the application form, which will be
separated from the rest of the form before shortlist selection takes place.

You can be assured that this information will be treated in confidence and will not be
available to shortlisting officers or interviewers.

1.Gender
Male Female

2. What is your ethnic group?

Please choose one selection from A to E and then tick the appropriate box within your chosen
section to indicate your cultural background.

A. White
British Irish
Any other White Background
B. Mixed
White and Black Caribbean White and Black African
White and Black Asian Any other Mixed Background
C. Asian or Asian British
Indian Pakistani
Bangladeshi Any other Asian Background
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D. Black or Black British

Caribbean African
Any other black background
E. Chinese or other Ethnic Group
Chinese Any other Background

3. Do you consider that you have a disability as defined by the Disability

Discrimination Act 1995?
This means long term illness, health problem or disability that limits your daily activities or
the work you can do. Yes No

4. Date of Birth

Where did you see this post advertised?

 Declaration of Offences

Before completing this form, please read the following notes carefully. Exempt

Rehabilitation of Offenders Act 1974

This post is exempt from the above act, as the nature of the job falls within the type of work
excluded from the Act by the 1975 and 2001 Exceptions Amendment. This means you must
declare on this form all offences, convictions, cautions, bindovers or any court cases you may
have pending. Convictions will not necessarily be a bar to employment with the council.
As this post involves working with or has access to children or vulnerable adults and/or their
records, we will require an enhanced Disclosure from the Criminal Records Bureau for the
successful candidate.

Have you ever been cautioned or convicted of a criminal offence? Yes No

Have you ever been disqualified from working with children or Yes No
vulnerable adults?
Do you have any unspent criminal convictions or cautions? Yes No
If you fail to disclose any criminal convictions or cautions, including those spent, it could
result in withdrawal of the job offer, dismissal or disciplinary action by the Authority.

If you do not have any, please write none.

Details of offence(s) Place and date of Judgement(s) Sentences(s)
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Possession of a conviction or caution will not necessarily mean that you won’t be appointed,
each case is considered on its merits. All information given will be treated in the strictest
confidence and will be used for this job application only.

I certify that, to the best of my knowledge, the information on this form is true and accurate. I
understand that if the information I have supplied is false or misleading in any way, it will
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automatically disqualify me from appointment or may after appointment lead to disciplinary

action, which could lead to my dismissal without notice.

Name (Please print)

Signed Date
 Guidance Notes
How to complete your application
The application form plays an essential part in choosing the right person for a job. It is the
information contained in your application and supporting statement that will decide
whether or not you are invited for an interview or to the next stage in the selection process.

What are selection criteria

Selection criteria are the skills, abilities, knowledge and perhaps qualifications necessary to
do the job. These are shown in the person specification. They are based on the key
responsibilities of the role, which are shown in the job description. The purpose of the
selection criteria is to help us to recruit the best person for the job objectively and fairly. The
selection criteria are an essential part of our recruitment process and will be used to decide
who is invited for an interview, or, the next stage of the selection process. The person
specification should help you to match your skills, abilities and Knowledge against the
selection criteria.

Personal details
Where it says ‘known as’, this is for example if your official documentation shows you as
‘Elizabeth’, but you like to be known as ‘Liz’.

Working in the UK
Under the Asylum & Immigration Act 1996, you will be required to provide proof of your
eligibility to work in the UK. We will need to see original documents. You will only be able to
work for us once we are sure that you are eligible to work in the UK. If you are unsure about
your status then you should contact the Home Office.

Current or most recent employment

We need you to provide us with you complete employment history, and any gaps in your
employment history of more than one month should be explained – for example, carers and
childcare responsibilities. We may ask for references to cover a full three-year history, which
may include time spent at school/further education. In addition to the standard reference
questions the employer/organisation will be asked about disciplinary offences relating to
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children, including "spent ones" and where the applicant has been the subject of any child
protection concerns and details of these. For this three-year history please provide full
postal addresses, including postcodes.

If you have been self-employed during the last three years, this means we will need to see
your tax returns for that period if you are successful.
If you have been claiming benefits in the past three years we contact the Benefits Office to
verify this if you are successful.

References will be taken up for short-listed candidates.

Qualifications & Training

Please give details of your education, qualifications and training, starting with secondary
school. If we have requested that you have a professional qualification for this job (like
GSCC, DfES etc.), you will need to provide us with the relevant original
certificates/registration documents.
Supporting statement and achievements
This section is your opportunity to tell us how you meet the criteria in the person specification. Take
each relevant item and tell us about your skills, experience, knowledge and achievements.

Give examples of what you have done which prove your ability. If the person specification says, ‘able to
organise activities’, you must do more than say, ‘I am an organised person’. Give an example by
describing something that you have done, which tells us about the skills you used and the steps that
you took.

You can use examples from your home life, time spent in education, voluntary work or from your
hobbies/interests if you do not have any formal experience.

Declaration of Criminal Offences

Please read this carefully before completion.

The Criminal Records Bureau (CRB), and Executive Agency of the Home Office, provides wider access to
criminal record information through its Disclosure service. This service enables organisations in the
public, private and voluntary sectors to make safer recruitment decisions by identifying candidates
who may be unsuitable for certain work, especially that involving children and vulnerable adults. The
CRB was established under part V of the Police Act 1997 and was launched in March 2002. You can get
more information about CRB at www.crb.gov.uk.

Declaration
We do not exclude people who are related to, or have a close personal relationship with our
councillors, employees or school governors. We will make sure that they do not take part in the
selection for this post.

Please make sure you read and sign/positively tick the declaration.

Monitoring
This Authority has an Equal Opportunity in Employment policy, which we ensure that we monitor to
ensure that our employees reflect the community we serve. The information provided will be treated in
the strictest confidence, is never available to the recruiting manager and will only be used for
monitoring purposes.
 Checklist

Before you submit your application, please check that you have: Tick Here
.

Read through the Job Description & Person Specification so that you know exactly
what the job entails and the skills, knowledge, abilities and perhaps qualification
required to do the job
Read through your application form and make sure that you have filled out all the
parts that we have asked you to
Given clear, step-by-step examples of your skills, abilities, knowledge and experience
Attached additional information if you have run out of space
Kept a copy of your completed application form and Job Description and Person
Specification
Made sure that your application form will be received by the closing date

NB if you are sending your form in the post, please ensure that you attach the
right amount of postage

What happens next?

Your completed application form will be used to decide whether or not you are invited for an
interview, or the next stage of the recruitment stage of the recruitment process. You will hear
from us shortly after the closing date if your application is shortlisted

Please send your completed application form to

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 Applicants Charter

The Council will Ensure your application is considered in line with

legislation, the Council’s recruitment and selection
policy statement and other policies and good practice.

Give you a telephone number of a person to contact

should you have any queries or want further
information, and a unique candidate number by which
the progress of your application can be tracked.

Take account of any specified needs of which you let us

know.

Process you application objectively, without bias and as

quickly as possible.

Contact you within four weeks of the closing date on the

advertisement if you are to be invited for interview.

Provide feedback from an interview if you request it.

Let you know, if you are offered a post, what checks and
clearances will be required before your appointment is
confirmed.

Investigate quickly and sensitively any complaints or

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concerns you may have about how your application was

handled and inform you of the outcome.

If you are disabled (as outlined in the DDA 1995, 2005)

we will consider carefully and implement what
reasonable adjustments you may require during the
recruitment and selection process and on appointment.