Mental Wellbeing Officer - Castleford, United Kingdom - Young Peoples Empowerment Project

Young Peoples Empowerment Project

Verified Company

Castleford, United Kingdom

2 weeks ago

Posted by:

Tom O´Connor

beBee Recruiter

Description

APPLICATION FOR EMPLOYMENT

Position applied for:

Full/Part-time /Casual:

Surname & Title

Forenames
N.I. Number

Address

Tel:
Home

Tel:
Mobile

Vaccination Status

As per the Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021, it is mandatory for anyone working in care homes from 11 November 2021 to have received a full course of Covid-19 Vaccinations.

Please confirm your vaccination / exemption status.

Do Not Vaccinated Yes ❒ No ❒

Do Fully Vaccinated Yes ❒ No ❒

Have Medically exempt (must be evidenced) Yes ❒ No ❒

Vaccinated with 1 dose and 2nddose booked before 11 November 2021 Yes ❒ No ❒

Education and Training
Have you ever been convicted of a criminal offence? Yes ❒ No ❒

Please tell us if:

There are any reasonable adjustments we can make to the job itself to help you carry it out

Do you have the right to work in the UK? Yes ❒ No ❒

Do you hold a current driving licence? Yes ❒ No ❒

Have you applied to Durbia Healthcare in the last 12 month? Yes ❒ No ❒

Have you ever been employed by Durbia Healthcare? If yes state where you worked

FULL EMPLOYMENT HISTORY - _You must provide your _
_FULL_ _employment history with no gaps_

Dates

From To

Employers name and address

Job title

Reason for leaving

REFERENCES - _Please provide details of two appropriate referees from previous employment; one must be your current or last employer. The referees should be your line manager, supervisor or HR Department and must be able to provide a company reference. If you are without two previous jobs you should provide the name of your senior school and college along with one personal referee from a member of the community (though not ones who are related to you)_

1. Name

2. Name
Position

Position

Address

Address

Tel No.

Tel No.

Please indicate how these people know you and about your work abilities, please state whether they are your current supervisor, manager, etc._

1

2

SUITABILITY TO WORK WITH VULNERABLE ADULTS - _Your answers below will be checked via a criminal records check with the relevant governing body._

Has your name been referred to the Secretary of State under any of sections 82, 83 and 84 of the Health and Social Care Act 2008 and Regulated Activities - Northern Ireland Care Council for inclusion in the list maintained by the Secretary of State of individuals who are unsuitable for work with vulnerable adults ("the list")

Yes ❒ No ❒

If yes has the Secretary of State:

Confirmed the inclusion of your name on the list ❒
Removed your name from the list ❒
Not yet completed their consideration of referral ❒

DECLARATION

I CONFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION FORM IS TRUE, COMPLETE AND NOT MISLEADING. I UNDERSTAND THAT THE PROVISION OF UNTRUE, INCOMPLETE OR MISLEADING INFORMATION ON THIS APPLICATION IS GROSS MISCONDUCT AND IF I AM OFFERED AND ACCEPT THE POSITION AND AT ANY TIME DURING THE COURSE OF MY EMPLOYMENT IT COMES TO LIGHT THAT I HAVE PROVIDED FALSE OR MISLEADING INFORMATION I WILL BE SUBJECT TO THE COMPANY'S DISCIPLINARY PROCEDURE AND SUMMARY DISMISSAL.

I UNDERSTAND THAT MY SIGNATURE ON THIS FORM CONSTITUTES MY CONSENT FOR THE PURPOSE OF THE DATA PROTECTION ACT 1998 AS REFERRED TO ABOVE.
Signature

Dated

Please return this form to:_

This is controlled document. It should not be altered in anyway without the express permission of the author or their representative. On receipt of a new version, please destroy all previous versions

Salary:
£22,500.00-£26,500.00 per year

Benefits: