Job Application Form

Cautions, Rehabilitation & Criminal Records:

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974, by virtue of the Exceptions Order 1975 as amended by the Exceptions (Amendment) Order 1986, which means that convictions that are spent under the terms of the Rehabilitation of Offenders Act 1974 must be disclosed, and will be taken into account in deciding whether to make an appointment. Failure to disclose any such convictions or cautions could result in disciplinary action or dismissal by The Yews RCH.

In addition, you are required to submit a Disclosure & Barring Service check. Any standard or enhanced disclosure made by DBS/SOVA will remain strictly confidential.

Have you ever been convicted in a Court of Law and/or cautioned in respect of any offence? Yes/No (Please circle)
If YES, please give details



Have you ever been dismissed/suspended for any pending case? Yes /No (Please circle)
If YES, please give details

Any information received will be completely confidential and will be considered only in relation to this application.

Because this position involves the care of vulnerable adults’ employment is dependent on the following:

1) Your written consent to obtain a standard/enhanced disclosure certificate from the Disclosure & Barring Service or an approved umbrella body.

2) Such a disclosure being acceptable to the company.

3) Proof of identity – birth or marriage certificate (where appropriate) and passport (if available).

4) Two satisfactory written references.

5) That you supply a photograph of yourself for retention in your records.

6) Evidence of physical or mental suitability for your work.

1) Training & development is the responsibility of all staff; you must keep yourself up to date with all the relevant training courses required to carry out your duties effectively. There are MANDATORY training & courses that you must attend and keep your certification on date, failure to attend and/or lapse on mandatory training requirements may result in disciplinary action taken against you or it could mean your shifts are withheld until your training has been suitably updated.

2) Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor. I agree that the organization reserves the right to require me to undergo a medical examination. In addition, I agree that this information will be retained in my personnel file during employment and for up to six years thereafter and understand that information will be processed in accordance with the Data Protection Act.

3) I agree that should I be successful in this application, I will, if required, apply to the Disclosure & Barring Service/Scottish Criminal Records Office for a standard or enhanced (as appropriate) disclosure. I also agree that the company may apply to my previous employers for references. I understand that should I fail to do so, or should the disclosure or reference not be to the satisfaction of the company, any offer of employment may be withdrawn, or my employment terminated.

4) I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered. I have read and understand all the above conditions of employment, and I wish to be considered for employment at The Yews RCH.