Job Application Form

Use the form below to apply for any of our open roles. If you would like to discuss any role in more detail or require further information, please email HR@sbc-residential.com or call 02088481800 (option 2).

Your data will be processed in accordance with our privacy policy.

Step 1 of 19

Post Applied For:(Required)

Working Hours:(Required)

Full Time

Part Time

PERSONAL INFORMATION

Name(Required)

Title First Last

Previous Names (if applicable):

National Insurance Number:(Required)

Email Address:(Required)

Address(Required)

Address Line 1 Address Line 2 City County / State / Region Post Code Country

Mobile Number:(Required)

Do you have a current full UK/European licence?(Required)

Yes

Driving Licence Number:

Date of Issue:

MM slash DD slash YYYY

Have you ever had any driving convictions or prosecutions?(Required)

Yes

If yes, please provide details:

Do you have a car available for use at work? (Must have current MOT and Business use insurance cover)(Required)

Yes

EMPLOYMENT HISTORY

CHILDREN’S HOME REGULATIONS STATE THAT WE DO NEED A FULL WORKING HISTORY FROM LEAVING SCHOOL TO DATE – FAILURE TO PROVIDE THIS WILL RESULT IN APPLICATIONS NOT BEING PROGRESSED. Please list in order, with the most recent first, the organisations that you have worked for. Stating whether the post was full time, part time, voluntary or unpaid work. Please include periods of unemployment and explain circumstances. All related workplace history will be verified verbally and in writing via a reference check.

Current or Most Recent Employer – Company Name:(Required)

Company Address:

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Dates of Employment (Start Date)(Required)

DD slash MM slash YYYY

Dates of Employment (End Date)

DD slash MM slash YYYY

Job Title:(Required)

Reason for Leaving:(Required)

Overview of Duties:(Required)

Reference Details

Reference Contact Name:(Required)

First Last

Reference Contact Job Title:(Required)

Reference Contact Number:(Required)

Reference Contact Email address:(Required)

Previous Employer 1

Previous Employer – Company Name:(Required)

Company Address:(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Dates of Employment (Start Date)(Required)

DD slash MM slash YYYY

Dates of Employment (End Date)(Required)

DD slash MM slash YYYY

Job Title:(Required)

Reasons for Leaving:(Required)

Overview of Duties:(Required)

Reference Details

Reference Contact Name:(Required)

First Last

Reference Contact Job Title:(Required)

Reference Contact Number:(Required)

Reference Contact Email Address:(Required)

Previous Employer 2

Previous Employer – Company Name:(Required)

Company Address:(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Dates of Employment (Start Date)(Required)

DD slash MM slash YYYY

Dates of Employment (End Date)(Required)

DD slash MM slash YYYY

Job Title:(Required)

Reasons for Leaving:(Required)

Overview of Duties:(Required)

Reference Details

Reference Contact Name:(Required)

First Last

Reference Contact Job Title:(Required)

Reference Contact Number:(Required)

Reference Contact Email Address:(Required)

Previous Employer 3

Previous Employer – Company Name:

Company Address:

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Dates of Employment (Start Date)

DD slash MM slash YYYY

Dates of Employment (End Date)

DD slash MM slash YYYY

Job Title:

Reasons for Leaving:

Overview of Duties:

Reference Details

Reference Contact Name:

First Last

Reference Contact Job Title:

Reference Contact Number:

Reference Contact Email Address:

Previous Employer 4

Previous Employer – Company Name:

Company Address:

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Dates of Employment (Start Date)

DD slash MM slash YYYY

Dates of Employment (End Date)

DD slash MM slash YYYY

Job Title:

Reasons for Leaving:

Overview of Duties:

Reference Details

Reference Contact Name:

First Last

Reference Contact Job Title:

Reference Contact Number:

Reference Contact Email Address:

Previous Employer 5

Previous Employer – Company Name:

Dates of Employment (Start Date)

DD slash MM slash YYYY

Dates of Employment (End Date)

DD slash MM slash YYYY

Job Title:

Reasons for Leaving:

Overview of Duties:

Reference Contact Name:

First Last

Reference Contact Job Title:

Reference Contact Number:

Reference Contact Email Address:

Gaps in Employment:(Required)

Please include periods of unemployment and explain circumstances. All related workplace history will be verified verbally and in writing via a reference check.

REFERENCES

Reference contacts must be your current and previous employer wherever possible. Referees should not be relatives or other family members. Please ensure your referee is aware that they may be asked to provide a reference if you are shortlisted for an interview.

Please tick the following box to confirm that: I authorise Silver Birch Care (Residential Services) to contact my references to confirm my past employment and professional activities. I also agree to release from liability all persons and companies providing this information. I understand and acknowledge that any offer of employment is conditional upon Silver Birch Care (Residential Services) being completely satisfied with the information provided as a result of this reference check.(Required)

I give my consent

I do not give consent

PERSONAL STATEMENT(Required)

You should use this opportunity to demonstrate how you feel you meet the criteria that is stated in the job specification relating to the post that you have applied for. Please remember the quality of your response to this section will determine whether or not you are shortlisted for an interview. You should describe your abilities, skills, knowledge, qualifications, and experience gained from your paid/voluntary/studies and hobbies.

EDUCATION AND QUALIFICATIONS(Required)

Please give details of: 1) School(s) / colleges / universities attended. 2) Dates attended (to-from). 3) Subjects studied. 4) Grades and qualifications achieved.

FURTHER TRAINING AND DEVELOPMENT(Required)

Please give details of further training taken ie. First Aid, Moving and Handling etc. 1) Dates attended (to-from). 2) Subjects studied. 3) Grades and qualifications achieved.

EQUALITY AND DIVERSITY MONITORING INFORMATION

Ethnic origin: please tick one box that best describes your ethnic origin.

White:

English, Welsh, Scottish, Northern Irish or British

Irish

Gypsy or Irish Traveller

Any other White background

Mixed or Multiple ethnic groups:

White and Black Caribbean

White and Black African

White and Asian

Any other Mixed or Multiple ethnic background

Asian or Asian British:

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background

Black, African, Caribbean or Black British:

African

Caribbean

Any other Black, African or Caribbean background

Other ethnic group:

Arab

Any other ethnic group

AGE GROUP

Please tick one box that fits your age group:(Required)

18-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65 years+

GENDER

Please tick one box that is appropriate to your gender:(Required)

Female

Male

Other

HEALTH

Is there anything regarding your current fitness or general health which may prevent you from carrying out any of the duties of the position that you have applied for? If so, please state the details here:(Required)

Have you been made subject to any order under any section of the Mental Health Act? If so, please write the details here:(Required)

How many days in the last two years have you been unavailable for work due to sickness?(Required)

DISABILITY DISCRIMINATION ACT 1995

Silver Birch Care (Residential Services) Limited aims to recruit and provide equal opportunities for disabled people who meet the requirements of the role applied for.

Do you consider yourself to have a disability?:(Required)

Yes

Prefer not to say

Please tell us if there are any ‘reasonable adjustments’ we can make to assist you in your application or with our recruitment process.

ASYLUM AND IMMIGRATION ACT 1996

Under section 8 of the above Act, it is a criminal offence to employ anyone who does not have permission to work in the UK. All applicants who are invited to interview will be required to provide documentary evidence of their right to work in the UK. All applicants who are subject to immigration control will be verified via the Home Office.

Are you subject to any legal restrictions in respect of your employment in the UK?(Required)

Yes

If yes, please provide details:

DECLARATION OF CRIMINAL OFFENCES

Because of the nature of our work for which you are applying, this post is exempt from the provision of the act, 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 considered ‘spent’ and, in the event of employment, any failure to disclose such convictions will result in withdrawal of the offer of employment or dismissal. Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position and the circumstances and the background of your offences. Any information will be treated confidentially.

Have you ever been cautioned, court-martialled, or have criminal convictions, whether as a juvenile or an adult?(Required)

Yes

If yes, please provide dates and details.

Do you have any criminal matters outstanding?(Required)

Yes

If yes, please provide dates and details.

Have you, at any time, during your employment history had any disciplinary action taken against you?(Required)

Yes

If yes, please provide dates and details.

Have you, at any time, during your employment history had any allegation made against you or concerns raised, which relate either to the safety and welfare of, or your behaviour towards, children and young people?(Required)

Yes

If yes, please provide dates and details.

Please confirm: 1) If you have an existing DBS Certificate. 2) What date it was issued. 3) DBS Certificate Number. 4) If you are subscribed to the Update Service?(Required)

All staff are required to complete a Disclosure and Barring Service Application Form (DBS) and this check will include the Protection of Children Act list (POCA). If you are successful at the interview you will not be able to commence work at Silver Birch Care (Residential Services) Limited until that form has come back satisfactorily.

ADVERTISING

Please tell us where/how you saw the advert for this job post(Required)

Do you know anyone that is currently working for Silver Birch Care? Please explain who and the nature of your relationship.(Required)

DATA PROTECTION ACT(Required)

Under the Data Protection Act 1998, Silver Birch Care (Residential Services) Limited reserves the right to collect, store and process personal data about applicants in so far as it is relevant to an application for employment.

This includes processing sensitive data for the purposes of monitoring Silver Birch Care (Residential Services) Limited’s equality and diversity policy. All personal information held by Silver Birch Care (Residential Services) Limited will be processed in accordance with the eight principles of the Data Protection Act.

I consent to the above terms.

Upload CV File(Required)

Max. file size: 2 GB.

PERSONAL INFORMATION

EMPLOYMENT HISTORY

Reference Details

Previous Employer 1

Reference Details

Previous Employer 2

Reference Details

Previous Employer 3

Reference Details

Previous Employer 4

Reference Details

Previous Employer 5

REFERENCES

EQUALITY AND DIVERSITY MONITORING INFORMATION

AGE GROUP

GENDER

HEALTH

DISABILITY DISCRIMINATION ACT 1995

ASYLUM AND IMMIGRATION ACT 1996

DECLARATION OF CRIMINAL OFFENCES

ADVERTISING

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