Thank You for Your Interest in Our Vacancy Within Pebbles Care, Partners in Care and Radical

Thank you for your interest in our vacancy within Pebbles Care, Partners in Care and Radical Services Ltd.

I would like to give you some further details about us. Pebbles Care, Partners in Care and Radical Services Ltd is a family orientated company and our homes cater for young people of either gender from the ages of 8 to 18. The main aim at Pebbles Care, Partners in Care and Radical Services Ltd is to offer stability, security and opportunity. The young people may have experienced difficulties in their lives and as a consequence have emotional and/or behavioural difficulties.

Please find enclosed the application form and job description which you requested, please note that you should possess a full driving licence and your minimum age should be 22. If you are successful, you will be working with vulnerable children and full training and an induction course will be provided.

We are required to check all potential employees with the Criminal Records Bureau. A past conviction will not necessarily debar you from working with us. You are therefore, required to declare any prosecutions, convictions or cautions you may have even if they would otherwise be reported as spent under the Rehabilitation of Offenders Act 1974 or if they are pending, on the separate declaration form and place in this in the separate envelope marked “Private & Confidential – Luiz Guilherme”. Please ensure all forms are completed correctly. This information will be treated with the utmost confidentiality.

Please read all documents carefully and return your application form (in the self addressed envelope provided) If you are short-listed for an interview, you will be required to produce original ID documents (for a DBS check) along with any original certificates as specified in your application.

Interview dates will be confirmed in due course, if you are selected, in writing

Yours sincerely

Vicki Robinson HR Co-ordinator

A Stepping Stone to a Brighter Future

Company Registration No. 4854937

Application for Employment

Please complete this form in full (incomplete application forms will not be accepted) and in writing using black ink. Where necessary please use the continuation sheets provided at the end of this form. CV’s will not be accepted.

Position Applied For Ref No

Location

Preferred Working Pattern Full Time Part Time Bank (please tick where appropriate)

Date of Application Please state where you heard about the vacancy

Closing Date of Application:

Please return to:-

HR Co-ordinator HR Department Pebbles Care Ltd 2 Wyther Lane Leeds LS5 3BT Tel: 0113 2653340 Fax: 0113 2782486

PART 1 - PERSONAL DETAILS

Surname

Forename(s)

Title Preferred Name Are you now, have you ever been, or were you at birth known by a different name? Please give details

Nationality Are you required to have a work permit?

Address (in full)

(Last 5 years of addresses required)

Postcode Postcode

Postcode Postcode Email Address

Telephone No

Mobile No

Evening No

National Insurance No

CRB No

Date of CRB

PART 2 – DRIVING DETAILS

Do you hold a full driving licence valid in the UK? (Yes/No)

Please give any details of penalty points with dates

Do you have the use of, or own a motor vehicle?

PART 3 – PRESENT EMPLOYMENT

Job Title Name & Address of Employer

Postcode

Date commenced with Month Year employer

Salary/wage/benefits

Briefly describe your present duties and responsibilities

Reason for leaving

PART 4 – EMPLOYMENT HISTORY SINCE LEAVING FULL-TIME EDUCATION All gaps in your employment must be accounted for Dates Name & Address of last employer, nature of Salary on Position Held From To business and your reason for leaving leaving (mm/yy) (mm/yy)

PART 5 – EDUCATION/QUALIFICATIONS

Please complete Part 5 (Education) from age 11. Please enclose copies of any certificates relevant to the position along with the application form. Continue on a separate sheet if necessary.

Dates Certificates/Qualifications School/College Date From To Awarded (mm/yy) (mm/yy)

PART 6 – PROFESSIONAL QUALICATIONS & MEMBERSHIPS Professional Qualifications & Memberships Date Achieved or Date Attended

PART 7 – RELEVANT TRAINING/STUDIES Date Name of Course

PART 8 – INTERESTS/HOBBIES

PART 9 – SUPPORTING INFORMATION

Please give your reasons for applying for the post and any additional information in support of your application and any relevant experience

PART 10 - REFERENCES

Please give details of two referees, the first of whom must be your past or present employer. The other referee must have known you for at least five years and should not be a member of your family.

Name Name Address Address

Postcode Postcode

Position Held Position Held

Tel No Tel No:

Email Address Email Address

Please tick here if you do not wish your present employer to be contacted prior to interview

Please supply any other names and contact details for all other care jobs you have had previously.

Name & Address of Employer Position Held

Do you have any family members or relations who have worked or who are existing employers within the company?

Please state ……………………………………………………………………..

Care Warnings/Disciplinary Issues

Please circle answer as applicable

Have you ever been dismissed or have you ever resigned in the face of a dismissal or warning? YES/NO

Has an order been made at any time for the purpose of removing a child from your YES/NO care or preventing a child living with you?

Have you ever been the subject of any allegations in relation to the safety and welfare of children, young people and/or vulnerable adults, either substantiated or YES/NO unsubstantiated?

Has an application made by you for registration of a voluntary or registered home YES/NO ever been refused?

Have you ever been prohibited from being a private foster parent? YES/NO

Have you ever been refused registration to be a child-minder or provider of day YES/NO care, or had your registration as either of these cancelled?

If you have answered yes to any of the above questions, you must supply details on a separate sheet of paper, place it in the sealed envelope marked confidential and attach it to your application form.

I have attached details as requested YES/NO

Declaration

I confirm that all information submitted is true and accurate, that there are no medical or other reasons that I know of which prevents me from undertaking the duties of the post and I understand that any misrepresentations may invalidate my application and if appointed may result in subsequent dismissal.

I also understand that this declaration must include details of any criminal convictions, cautions, reprimands and final warnings and any other information that may have a bearing on my suitability for the post. I understand that an enhanced disclosure from the Criminal Records Bureau will be sought in the event of a successful application.

I confirm that the information provided in this application is truthful and. I have omitted no fact that could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK, declared CRB matters and satisfactory references. I expressively consent to personal data contained within this application being recorded for the purpose of accessing suitability of the post and may form the basis of any subsequent personnel file.

Signed: ……………………………………………………

Print Name: ……………………………………………………

Confidential – Equal Opportunities in Employment – Monitoring Form

We maintain the belief of equal opportunities and oppose all forms of unlawful and unfair discrimination on the grounds of colour, race, nationality, ethnic or national origin, sex, marital status, disability, sexual orientation, religious or belief or age. As part of this process, we need to monitor our recruitment process. However, please note that completion of this form is optional.

It would be very helpful if you could complete the following information which relates only to monitoring purposes and is not used in the selection process. This information is treated as confidential.

On receipt it will be separated from the application form before short listing takes place.

Ethnic Origin

This is the origin of your family rather than your nationality. For example, you could be British and your ethnic (family) origins could be any of the ones listed below, or a combination of them.

Please identify your ethnic origin by putting a tick in ONE of the boxes below, or by giving your own description in the space provided.

Other White White British Irish Gypsy/Romany background

White & Black White & Black Other Mixed Mixed White & Asian Caribbean African background

Black or Black Any Other Black Caribbean African British background

Asian or Asian Indian Pakistani Bangladeshi Other Asian background British

Other (please Other ethnic groups Chinese specify)

Disability Guidance

Where an applicant has a disability and they meet the essential criteria of the post they are automatically short-listed for interview This positive action helps ensure people with disabilities get their fair share of jobs.

The Disability Discrimination Act 2005 says that a person is disabled if they have a mental or physical impairment or long term health condition which has a substantial adverse effect on their ability to carry out normal day-to-day activities.

If you consider yourself to be disabled please let us know We would appreciate advice on help we can give you to enable you to attend, or participate in the interview At the interview you will be asked if you have any disability which could affect your ability to do the job, and, in compliance with the Disability Discrimination Act 1995, you will be asked what reasonable adjustments we might arrange to assist you.

Do you consider yourself to be disabled as set out in the Disability Discrimination YES/NO Act? (select as applicable) If YES, please describe your disability

If you need any assistance to attend or participate in the interview, please give details.

Gender

Please identify your gender by putting a tick in ONE of the boxes below.

Male Female Prefer not to say

If you are undergoing the process of gender reassignment, please tick the box that applies to your future gender.

Please identify your age range by putting a tick in ONE of the boxes below.

18-25 25 – 35 35 – 45 45 – 55 Over 55 Prefer not to say

Religion

Please identify your religion by putting a tick in ONE of the boxes below

Christian Buddhist Hindu Jewish Muslim Sikh Other religion No religion Prefer not to say

Sexual Orientation

Please identify your sexual orientation by putting a tick in ONE of the boxes below

Bisexual Gay man Gay women/lesbian Heterosexual/straight Other Prefer not to say

Criminal Convictions Declarations (Rehabilitation of Offenders Act 1974)

Details of Criminal Record

As all posts within the Company will involve contact with vulnerable children, you are required to disclose details of any criminal record and declare all convictions and cautions whether or not they would be spent under the Act. Only relevant convictions and other information will be taken into account, so disclosure of a criminal record may not necessarily be a bar to obtaining this position.

Have you ever been convicted by the court, cautioned, reprimanded or given a final warning by the police? (Note that the post you have applied for is exempt from the Rehabilitation of Offenders Act 1974; this means that all convictions, cautions, reprimands and final warning on your criminal record must be disclosed). Please tick as appropriate: □ Yes □ No

Please use the envelope provided marked ‘Private & Confidential – Luiz Guilherme’.

If yes, please give full details of offences, penalties and dates and use the envelope provided enclosing it with the application form.

Are you aware of any police enquiries undertaken following allegations made against you, which may have a bearing on your suitability for this post?

Please tick as appropriate: □ Yes □ No

If yes, please give full details and use the envelope provided enclosing it with the application form.

Working Time Regulations – 48 Hour Week Opt Out

The Working Time Regulations Act 1998,effective from 1st October 1998,state that a workers average working time shall not exceed 48 hours per week unless the worker agrees in writing that the limit shall not apply in his/her case.

You have indicated your agreement to work in excess of an average 48 hours per week.

Please sign the declaration below and return the form to Pebbles Care/Partners in Care/Radical Services Ltd*, 2 Wyther Lane Leeds 5 LS5 3BT.

Pebbles Care, Partners in Care & Radical Services Ltd is required to retain this form to allow for inspection by the enforcing authority.

DECLARATION

I agree to work, when necessary, in excess of 48 hours per week. I understand that I may terminate this agreement at any time subject to giving 13 weeks notice, by requesting and completing a cancellation form.

Name ______

Location ______

Signature ______

Date ______

To be retained in the individual’s personnel file

*please delete as appropriate