Support Worker

Personal Details

Surname: .............................................................. First Name: ..............................................................

Address: .............................................................................................................................................................

............................................................................... Postcode: ..................................................................

Tel. (MOBILE) ....................................................... Tel. (HOME) ..............................................................

Email address ...................................................... Date of Birth ..............................................................

Notes for Applicants

Your application will be judged against the person specification and the job description, which is the list of essential

requirements for the post. You should address each point of the person specification, giving details of what skills,

experience and knowledge you have in these areas. Always be specific. Make positive statements and do not use

general phrases such as “I have the necessary skills ...” or “I am confident I can do the job well ...” The short-listing

panel needs to how and why. You should give details of duties carried out in your current and previous jobs or any

relevant experience gained outside paid employment. Attach any additional notes securely to the application form.

CV’s will NOT be accepted.

All applications are considered in accordance with the organisations’ policy on Equal Opportunities.

Late applications will NOT be accepted.

Application forms should be returned to:

Human Resources Department, 60-62 Clarence Street, Hull. HU9 1DN

Where did you see this post advertised? ............................................................................................................

Are you related to/partnered with anyone associated with [Employer hidden]? YES NO

If YES Name ............................................................. Relationship ...............................................................

Do you have a disability? YES NO

We guarantee an interview to applicants who meet the person specification who have a disability

Education / Qualifications / Training / Courses

Date Details Grade(if appropriate)

Work History (Paid and Unpaid)

Dates Details Reason for leaving

Include name and address of employer, duties and responsibilities

From To If you have gaps in your work history please specify dates and explain a reason why.

Please continue on a separate sheet if necessary

Suitability for the Post - Please complete all sections

Avocet provides 24 hour support for clients, which includes the need to work flexible shifts including night shifts.

Are you able to meet such flexible demands now and in the foreseeable future YES NO

It is an essential requirement of this post that all training identified as necessary is achieved and kept up to date in

order for you to maintain the position of this post with the charity if your application is successful.

Are you prepared to accept this requirement? YES NO

You will be required to use your own initiative in this post and to work unsupervised. Can you give an example when you

have been in such a position either in the working situation or in your private life?

You will be working as a member of a team of support workers. Have you previously worked as a member of a team and

can you give an example?

An essential part of the post is supporting clients to live a normal life.Do you have experience in working with people who

have needed care and support and can you give an example?

Understanding all domestic duties, which include providing a choice of fresh nutritional meals for clients, is

fundamental to this post. Are there any areas which may prove problematic to you?

It is essential that you are able to effectively communicate with clients, their families and friends both verbally and in

writing. Have you had any such work experience of relating to “customers” and can you give examples?

Please continue on a separate sheet if necessary

Salary Details

Current Salary ...........................................................

Do you hold a current UK Driving Licence YES NO

References

Please give the names and addresses of two referees

1. Name: (Present/most resent employer or tutor) .............................................................................................

Address: .............................................................................................................................................................

.................................................................................. Postcode: .................................................................

Telephone ................................................................ Email ........................................................................

May we approach referee prior to interview? YES NO

Notice period required if currently employed: ..................................................................................

2. Name: (Preferably former employer or tutor) .................................................................................................

Address: .............................................................................................................................................................

.................................................................................. Postcode: .................................................................

Telephone ................................................................ Email ........................................................................

May we approach referee prior to interview? YES NO

Notice period required if currently employed: ..................................................................................

Have you ever been dismissed from any post? YES NO

If YES please give details ...................................................................................................................................

.............................................................................................................................................................................

Important please read and complete this section

REHABILITATION OF OFFENDERS ACT 1974 (Exemptions) ORDER 1975

Due to the nature of the work for which you are applying, you must declare any previous convictions. This post is exempt

from the provisions of section 4 (2) of the REHABILITATION OF OFFENDERS ACT 1974 (Exemptions) ORDER 1975.

Applicants are therefore not entitled to withhold information about convictions which for other purposes are “spent” under

the provisions of the Act and in the event of employment, any failure to disclose such convictions could result in

dismissal or disciplinary action by the organisation. Any information given will be completely confidential and will be

considered only in relation to an application for positions to which the order applies.

Have you ever had any criminal convictions? YES NO

If YES, please give details on a separate sheet in a sealed envelope to “Lead Counter Signatory, [Employer hidden]”

I confirm that the information given on this application is, to the best of my knowledge correct.

Name ............................................................ (Please Print) Signature ........................................................................

Date ................................................................................

Ethnic Monitoring Questionnaire

[Employer hidden] has a policy of equal opportunities. Everyone who is eligible to join [Employer hidden] whatever their race, colour,

ethnic or national origins, will receive equal treatment when applying for jobs. We want to find out whether this policy is

working and to take steps to ensure further progress is made to achieve equal opportunities. To do this we need to know

about the race or ethnic origin of the people who apply to join [Employer hidden]. We are therefore asking you to complete

the following questionnaire. Your answers will be treated confidentially and will not effect your job application in any way.

May we thank you in advance for your co-operation

Please read all the categories and then tick the box that you most identify with.

1. White (cid:0)

Any White background(specify if you wish).......................................................

2. Asian

Indian (cid:0)

Pakistani (cid:0)

Bangladeshi (cid:0)

Any other Asian background (specify if you wish) ..............................................

3. Black

Caribbean (cid:0)

African (cid:0)

Any other Black background (specify if you wish) .............................................

4. Chinese

Any other Chinese background (specify if you wish) .........................................

5. Mixed ethnic background

White and Black Caribbean (cid:0)

White and Black African (cid:0)

White and Asian

Any other mixed ethnic background (specify if you wish) ...................................

6. Any other ethnic background

Any other ethnic background(specify if you wish) .............................................