AYA Job Application Form

Position Applying For

Personal Details

Name
Address

Education and Training

Please provide details of all academic, technical and professional qualifications you have achieved including dates awarded. (This should include GCSE’s, NVQ’s or equivalent, A-Levels or equivalent, and Degrees).
Please include: Qualification title, Qualification type, Grade/ level & Date awarded
Please include: Professional body, Membership type, Membership number & Date of registration

Employment History

Please include: Employer, Job Title, Dates of Employment (MM/YY) & Reason for Leaving

Gaps (Since Leaving Full-Time Education)

Please include: Dates (MM/YY) & Reason for gap in employment

Cover Letter / Supporting Evidence

Please provide a cover letter / any supporting evidence you wish to include in your application, that is additional to the information on your CV and in this form.
Drop files here or
Max. file size: 20 MB, Max. files: 4.

    Warnings, Disciplinary Issues and Allegations

    Have you ever been dismissed from employment or have you ever resigned from a post due to a warning and/ or in the face of a dismissal?
    Have you ever been the subject of any allegation in relation to the safety and welfare of children, young people and/ or vulnerable adults whether substantiated or not?
    Have you ever experienced social care involvement in your personal life?

    Driving License

    Do you hold a valid UK driving licence?
    DD slash MM slash YYYY

    Disclosure of Criminal Record Information

    As a provider of supported accommodation and residential services for vulnerable adults, families, children and young people, AYA needs to be particularly careful about the character and background of our employees whose work will bring them into close contact with at-risk individuals and/ or groups. Please answer the following questions truthfully and accurately to the best of your knowledge. Any disclosures provided will be completely confidential and will be considered only in relation to an application for positions to which the order applies. Relevant criminal convictions and other associated information will be discussed at the interview in order to assess job-related risks.
    Do you have any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) by SI 2013 1198?
    Have you ever been barred, excluded or prevented from working with children or vulnerable adults in the course of any employment, regulated or controlled activity, as defined by the Safeguarding Vulnerable Groups Act 2006, whether paid or unpaid?
    Have you ever been suspended from any professional practice or subject to any suspension order by any local authority, professional body, inspectorate or similar licencing/ registration authority that may reasonably be regarded as preventing you from working with children or vulnerable adults?

    Referees

    Referee 1 Name
    Address
    May we contact this person prior to interview?
    Referee 2 Name
    Address
    May we contact this person prior to interview?

    Please refer to www.gov.uk/government/publications/dbs-filtering-guidance for full details on filtering and offences that will never be filtered.

    All posts at AYAt will be subject to an enhanced Disclosure and Barring Service (DBS) disclosure.  By applying for a post at AYA, you, the applicant, agree to undergo this process and abide by AYA’S policies and procedures regarding obtaining a DBS disclosure.

    Please confirm the following:

    Consent
    Are you currently registered with the Disclosure and Barring Service (DBS) Update Service?
    Consent

    Disclaimer

    The Disqualification for Caring for Children Regulations 2002 applies to anyone employed in a registered or voluntary children’s home. The Regulations set out grounds for disqualification from caring for children. These fall into three main areas: 1. Where a child of the individual has at any time been the subject of a care or similar order, or where an order has been made with the purpose of removing a child from the individual’s care or preventing the child from living with him/her. 2. Where the person has been convicted of an offence specified in Schedule 1 of The Children and Young Persons Act or one involving injury or threat of injury to another person. 3. Where:
    • The person has been concerned with a voluntary or registered children’s home which has been removed from the register; or
    • An application by the person for registration of a voluntary or registered children’s home has been refused; or
    • The person has been prohibited from being a private foster parent, or the person has been refused registration to be a child minder or provider of day care, or had his/her registration cancelled.
    Please confirm the following: I have read and understood the above and declare that I am not disqualified from caring for children under The Disqualification for Caring for Children’s Regulations 2002.
    Name
    DD slash MM slash YYYY

    Applicant Declaration

    I certify that to the best of my knowledge, the information provided within this form is true and accurate. I understand that any false or misleading information given in response to any questions, or the failure to disclose any relevant information, may result in the withdrawal of any offer of employment or the termination of any contract of employment entered into. I understand that if my application is successful, my appointment is subject to receipt of three satisfactory references, a satisfactory DBS disclosure and a proof of eligibility to work within the UK.
    Name
    DD slash MM slash YYYY
    This field is for validation purposes and should be left unchanged.