1 - Introduction
All questions marked with a * are mandatory. You must complete these before moving onto the next section.
4 - Referees
Please give details of two people to whom you are not related and to whom a request for a reference can be made;
one should be your current employer, or if you are currently unemployed, your last employer. In the case of
school/college/university leavers, your tutor. In certain circumstances a reference may be requested from
any of your previous employers.
Any offer of employment will be subject to receipt of satisfactory references and DBS check and may
be withdrawn in the event of a failure to receive them.
5 - Personal Statement
Using the job description and person specification as a guide, please give details of any experience
or skills which you feel demonstrate your suitability for this post.
I understand that any employment, if offered, will be subject to the information on this form being correct,
and I can confirm that no valid information has been wilfully withheld. I understand that if I am appointed, I am
liable to dimissal without notice if the information on this form is later proved to be inaccurate.
I agree with the above terms
You will be asked to also physically sign a copy of this document before before any offer of employment is made.
Protecting your personal information
The Caldecott Foundation retains on file information (including health and equalities data) from this form and any
attached documents. This is required for recruitment and equal opportunities monitoring purposes, the payment of staff
and the prevention and detection of fraud. All information will be dealt with in accordance with the data protection legislation.
6 - Criminal Record Disclosure
Criminal record disclosure and Rehabilitation of Offenders Legilsation.
Because of the nature of the work you will be asked to undertake it as exempt from the povisions of the
Rehabilitation of Offenders Legilsation. This means that you must provide us with all information relating
to any form of conviction at any time in your lifetime. This includes such matters as police cautions,
anti-social behaviour orders or informal warnings as well as any other form of conviction whether you were
sent to prison or not. You are not entitled to withhold any information whether the sentence is spent
or not. Any information that you give will be completely confidential and will only be considered in
relation to the post that you are applying for. A criminal record may not be a bar to obtaining employment.
If you have been registered on any list relating to vulnerable adults or children and your registration has
been confirmed you should be aware that you would be committing a criminal offence in applying for a post in
a caring position.
Any failure to notify of any form of conviction or any other form of misleading or false information now or
at any time in the future could result in disciplinary action that may lead to the termination of your employment
at any time during the course of your employment.