Crescent Meadow Children's Home - Employment Application FormApplication for EmploymentThank you for expressing an interest in working with Crescent Meadow Children's Home. Our aim is to provide safe, nurturing, trauma-informed and child-centred care in a stable, family-style environment, supporting children and young people to achieve positive outcomes.Guidance for completion:Please familiarise yourself with Crescent Meadow Children's Home, Glenmorag House, and the job description for the role you are applying for.Please complete all sections of the form to avoid delays with your application.Read through the job description for the role you are applying for before you begin.Personal DetailsPosition Applied forSelect an optionRegistered ManagerResponsible IndividualSenior Residential Care WorkerResidential Care WorkerTeam LeaderBank StaffLocation of Service: Glenmorag House, Harley Drive, Wythenshawe, Manchester. Contracted hours depend on the role applied for (see job description) — 168 hours for Residential staff, no set hours for Senior staff, Responsible Individual or Registered Manager.TitleSelect an optionMrMrsMissMsDrOtherFirst NameAll Middle NamesSurnamePreferred NamePrevious namesDate of BirthNationalityDo you have legal right to work in the UK? Yes NoNational Insurance numberDo you hold a UK driving licence? Yes NoHave you any convictions? Yes NoIf yes, please provide detailsCurrent home addressContact number(s)Email addressNext of KinNameRelationship to youContact numberEmail addressAddressWhere did you hear about the vacancy?Have you been referred by an existing employee? Yes NoIf yes, please state whoEmployment & Education HistoryPlease provide your full employment and education history in chronological order, starting with your secondary school. Include any college, university or other learning establishment, whether in the UK or overseas. Include all employment, whether paid or voluntary, regardless of whether you consider it relevant to the role. Missing information will lead to delays with your application. Any gaps must be explained in the next section.For each entry please give: Name of company / educational establishment — Job role / course title — Start date (MM/YY) — Leave date (MM/YY) — Reason for leaving.Full employment and education historyGaps in Employment / EducationPlease look over your full employment / education history above and provide an explanation of any gaps in chronological order. State a clear reason for any gaps and how you were supporting yourself during that time, including any benefits you were in receipt of.For each gap please give: Gap start date (MM/YY) — Gap end date (MM/YY) — Reason for the gap.Gaps in employment / educationQualificationsPlease include details of any qualification you believe is relevant to the role you have applied for. Certificates may be requested at interview or at the point of a job offer being made.For each qualification please give: Name of course — Date completed / certified.QualificationsApplicant Specific QuestionsWhy do you want to work for us?Briefly outline your skills and experiences that make you a good fit for this roleDo you hold an enhanced DBS that is registered on the online update service? Yes NoIf yes, please provide the full certificate number and confirm whether this check covers both the children's and adults' barred list.DeclarationsYou must supply detailed information within this section. Failure to disclose any required information may result in your application being withdrawn.Do you, or have you ever had, any form of relationship with any Crescent Meadow Children's Home staff member or service user? Yes NoIf yes, please provide full detailsDo you currently work, or have you ever previously worked, for Crescent Meadow Children's Home either directly or through a recruitment agency or other third party? Yes NoIf yes, please provide full detailsHave you ever been found guilty of committing an offence, or of having done the act or made the omissions with which you were charged in any proceedings brought by a local authority, in relation to the care of a person under the age of 18? Yes NoIf yes, please provide full detailsHave you ever been convicted / cautioned / warned of an offence (other than a motoring offence not resulting in disqualification) in any criminal proceedings in any court of the UK or elsewhere? Yes NoIf yes, please provide full detailsHave you ever been requested to attend a Disciplinary Hearing where a Disciplinary Penalty has been imposed against you? Yes NoIf yes, please provide full detailsAre there any criminal or employment disciplinary proceedings currently pending against you? Yes NoIf yes, please provide full detailsHave you ever had social care involvement for your own children or children in your care? Yes NoIf yes, please provide full detailsHave you ever been subjected to a DBS referral? Yes NoIf yes, please provide full detailsHave you ever committed one of the offences set out in the schedule to the Disqualification for Caring for Children Regulations 1991 (including offences against children or any offence involving injury or threat of injury to another person)? Yes NoIf yes, please provide full detailsDo you or have you ever owned or been financially involved in a business? Yes NoIf yes, please provide full detailsDo you have any other declarations you may wish to alert us to?Section 7: Disclaimer and SignaturePlease read carefully the statements below and confirm your agreement:The information set out in this form is, to the best of my knowledge, true and complete.I hereby authorise Crescent Meadow Children's Home to conduct any necessary checks to verify the information recorded on this form.I understand that my appointment and employment is conditional on the verification of the information I have supplied.I understand that it may be a criminal offence to attempt to obtain employment by deception and that any intentional misrepresentation, omission of material fact or deception will cause the immediate withdrawal of an offer or dismissal if already employed.I understand that this information will be held by Crescent Meadow Children's Home for the sole purpose of assessing my suitability for the position I have applied for.I understand that, except where required by law, my details will not be disclosed to any third party. Details of successful applicants will be held as part of personnel files.I understand that under the Data Protection Act, I will have the right to request these details at any time in writing.I understand that if I am unsuccessful then the details will be kept for up to a maximum of 6 months, after which time they will be shredded.I hereby declare that I have not been dismissed from any previous employment for any reason connected with an actual or alleged Child Protection issue under Disqualification from Caring for Children Regulations (1991) or any other regulatory or statutory law.I hereby authorise Crescent Meadow Children's Home to conduct all required employment, character, education and Enhanced DBS referencing and consent to enquiries regarding my status being made for this purpose.I confirm my consent to account for any gaps or anomalies in my application, employment and education, where I may be asked to provide further information to enable Crescent Meadow Children's Home to carry out relevant checks to satisfy referencing requirements as per the Safer Recruitment guidelines.I confirm / authorise that an enhanced DBS search may be undertaken prior to / during my employment.If I have lived / worked outside of the UK for more than 6 months within the last five years, I understand that I will be required to provide a Certificate of Good Conduct for the country (or countries) I have lived / worked in and I will be liable for the cost of this.I understand that if, during my employment with Crescent Meadow Children's Home, I commit any act that brings actual or potential harm to a young person, Crescent Meadow Children's Home have a statutory duty to report this to the DBS and relevant registered bodies or authorities, and that this may prevent me from working with young people again in the future. I confirm I have read and agree to all of the statements aboveFull NameSignature (please type your full name as your electronic signature)DateSubmit Application