CHILDREN & YOUNG PEOPLE’S MENTAL HEALTH PROMOTION WORKER

A1. Personal Details

A2. Present or Most Recent Employer / Employment

A3. Previous Employment (In Date Order, Starting with Most Recent)

Please state all employment and voluntary work or gaps in employment

A4. Education & Training

A5. Essential and Desirable Criteria – See Enclosed Person Specification

A6. This section is only relevant if the job description/person specification states a driving licence is essential for the role.

A7. Rehabilitation of Offenders Act 1974 & Disclosure

If the job you are applying for is regulated and exempt from the provisions of the Rehabilitation of Offenders Act 1974 (ROA) you must not withhold information about convictions, which for other purposes are considered “spent” under the Act.  You must also disclose details if you are currently the subject of a police investigation / proceedings which could result in a conviction, caution or bind over order. Any information given will be treated in the strictest of confidence and will only be considered in relation to applications for such posts.   The Association supports the rehabilitation of offenders and possession of a conviction will not necessarily mean unsuitability for employment in exempt posts.  All cases will be examined on an individual basis and given full and fair consideration. 

A8. Reference Details

Please give the names, addresses and telephone numbers of two people who would be willing to provide a reference concerning your application.  Referees should be your present and previous employers, who will also be asked for information specifically about your attendance record.  Note:  Employment references from your present and previous employers will be required prior to appointment.   Any offer will be subject to these being satisfactory to Merseyside Youth Association Ltd. If you have not previously been employed please include details of a personal referee (preferably somebody who has known you in a professional capacity for at least 2 years) If you have been involved in voluntary work/placements, provide contact details.   If you have been in any full time education, provide details of a course tutor/teacher who will be able to comment on your suitability for this position.

A9. Declaration

I Declare that the information given on this form is to the best of my knowledge correct. I understand that the giving of false or misleading information may lead to disqualification and, if appointed, may lead to my dismissal. Furthermore, I understand that the information will only be used for recruitment and selection purposes and that it will only be kept on file by the Association for 6 months thereafter. However, if I am appointed to the post then the information that it contains will be used to form part of my personal file for employment purposes (except for disclosure information, if applicable, which will only be kept for 6 months).

Equal Opportunities Monitoring

Merseyside Youth Association Ltd. is aiming to achieve equality of opportunity in employment through its policies and procedures. All applications will be short listed based on the skills, knowledge and experience of the candidate. To enable us to monitor our policies and procedures we would be grateful if you would answer the following questions. The information provided by you will be treated as confidential and will only be used for monitoring purposes. This section will be detached from the form prior to short listing and the Selection Panel will not see it.

B2. Racial Origin

What best describes your ethnic origin? (Please tick relevant box)

B3. Religion/Belief

Please tick appropriate box

B4. Gender

Please tick appropriate box

B5. Marital Status

B6. Do you consider yourself to have a disability?

B7. Age Band

B8. Sexuality

Please tick appropriate box

A9. Declaration

I Declare that the information given on this form is to the best of my knowledge correct. I understand that the giving of false or misleading information may lead to disqualification and, if appointed, may lead to my dismissal. Furthermore, I understand that the information will only be used for recruitment and selection purposes and that it will only be kept on file by the Association for 6 months thereafter. However, if I am appointed to the post then the information that it contains will be used to form part of my personal file for employment purposes (except for disclosure information, if applicable, which will only be kept for 6 months).