Application form

Position applied for:

Right to work in the UK:

I am legally entitled to work in the UK: YesNo

Personal details:

Title:

First name:	Last name:
Telephone number:	Email address:

Postal address including postcode:

What is the best time to call your regarding your application?

Do you hold a current, full driving licence?

Do you have a current DBS? YesNo

CV upload:

Please select and attach your CV:(file size is limited to 2mb and only the file types .pdf, .doc, .docx, .ppt, .pptx and .odt are permitted)

Rehabilitation of offenders:

Do you have any unspent conditional cautions or convictions under the Rehabilitation of Offenders Act 1974? YesNo

Do you have any adult cautions (simple or conditional) or spent convictions that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020? YesNo

The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020) provides that when applying for certain jobs and activities, certain convictions and cautions are considered ‘protected.' This means that they do not need to be disclosed to employers, and if they are disclosed, employers cannot take them into account.
If you do not disclose something in your application that could prevent you working with children this could result in you being referred to the police and/or DBS as it is a criminal offence for any person who is barred from working with children and/or vulnerable adults to apply for a role in a regulated activity.
If you have made a declaration in relation to a conviction that does not threaten the safety of the vulnerable people we support we will consider your application and explore further during the recruitment process.

Employment history:

Have you previously been employed by a service within Autonomy Care Group? YesNo

As part of our regulatory responsibilities and in line with our safer recruitment commitment we are obligated to ensure we have full employment history with an explanation of any gaps, please tell us about periods of non-employment (if applicable):

References:

We require a reference from your current and previous employer. There may be a requirement to obtain further references.

Reference details must include the following: Company Name, Referee Name, Telephone & Email, Dates of Employment and your reason for leaving.

Reference details (From your current or former employer):

Reference details (From another previous employer or a character reference):

Are you applying for a position at Autonomy Plus within our Children's home? YesNo

Supporting statement:

Please provide details of any personal or professional experience to support your application, tell us about your values and what you would bring to the role / company.

General Data Protection Regulations

We need to collect and hold data about you in order to process your job application. We would like to obtain your permission (informed consent) to hold this data. Please indicate that you agree to us holding your data for a period of up to 12 months by ticking this box.
Please tick

For more information on your consent and the data we hold please tick here:View

Disability:

The Equality Act 2010 defines a disability as a ‘physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-today activities’. An effect is long-term if it has lasted, or is likely to last, more than 12 months.
Do you consider that you have a disability under the Equality Act (please tick)? YesNoPrefer not to say

Declaration:

I declare that to the best of my knowledge and belief the information contained in this application is correct. I accept that providing deliberately false or misleading information may result in my dismissal. I consent to this information being held on file and treated as part of any subsequent contract of employment. I agree to any company within the Autonomy Care Group to use and hold my data as detailed above and in line with legislation.
Please tick

How did you hear about us?