The Caldecott Foundation

Application for Employment

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1 - Introduction

All questions marked with a * are mandatory. You must complete these before moving onto the next section.

2 - About you


Our staff play a vital role in providing excellent services to the children and young people in our care.
To help achieve this we will train you to do your job and encourage you to look for every opportunity to use
your skills and abilities. This is your opportunity to tell us as much as possible about yourself and will help
us make a fair decision in the selection process.

Please ensure that you compelete ALL sections.

Both Home Alternative None

The Foundation does not discriminate on the grounds of age.

Yes No Yes No Yes No Yes No
Yes No Yes No Yes No Yes No Yes No

3 - Your Employment

Present or most recent employment details

Qualifications achieved from secondary, higher and/or further education. In the qualifications section include GCSE/O levels, A levels or equivalent,
NVQs, work based courses and any further education

Previous Employment

Please give details of all employment.
You must explain any gaps in your job history (including periods of unemployment).

Membership of Professional Organisations and Institutions

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be withdrawn in the event of a failure to receive them.

Reference 1

Yes No

Reference 2

Yes No

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.

Yes No Yes No

7a - Disability Statement

The Caldecott Foundation aims to be a fair employer and is committed to equality of opportunity for disabled people.
Applications from disabled people are welcome. All disabled applicants who meet the minimum criteria will be guaranteed
an interview. At interview, we have a policy of providing appropriate access and equipment to ensure that disabled people
are considered on an equal basis. If you would like any further assistance or advice about this application we will try to help.

In order to help us fulfil our aims, please answer the following questions:

Yes No Yes No

The Disability Discrimination Act 1995 defines disability as "a physical or mental impairment which has a substantial and long-term adverse affect on an individual's ability to carry out normal day-to-day activities."

Induction loop or other hearing enhancement
Keyboard for written tests
Assistance in and out of vehicle
Wheelchair access
Sign language interpreter (please state type below)
Someone with you at the interview (e.g. advocate or facilitator)
Accessible car parking
Accessible toilet

7b - Equal Opportunities Monitoring Form

The Caldecott Foundation values diversity in its workforce and aims to recruit and value a workforce that reflects the diverse make-up of the community.

As part of our recruitment process you are required to complete this monitoring form. This information will be separated and will not form part of the selection process. We expect all our employees, and prospective employees, to support our aim to build a diverse and representative workforce.

Male Female

The information you have given will only be shared with the recruiting manager if you are shortlisted. This is to enable appropriate, reasonable accommodations to be made to our selection processes and to provide facilities where necessary.

It will be treated as confidential.
Thank you for providing this information.

Protecting your personal information
The information you have provided will be retained and used by the Caldecott Foundation only for the purposes of monitoring the composition of the workforce and the fair application of policies and procedures in line with our Equality Policy Statement.

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