avocet trust
supporting vulnerable people
SUPPORT WORKER APPLICATION FORM
Head Office: 60-62 Clarence Street, Hull. HU9 1DN
W. www.avocettrust.co.uk E. info@avocettrust.co.uk T. 01482 329 226 F. 01482 329 337
Company No. 2647631 Charity No. 1004537
Application for the post of
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 Avocet Trust?
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
From
To
Details
Include name and address of employer, duties and responsibilities
If you have gaps in your work history please specify dates and explain a reason why.
Reason for leaving
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.
NO
Are you able to meet such flexible demands now and in the foreseeable future
YES
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, Avocet Trust”
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
Avocet Trust has a policy of equal opportunities. Everyone who is eligible to join Avocet Trust 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 Avocet Trust. 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.
Any White background (specify if you wish).......................................................
(cid:0)
Indian
Pakistani
Bangladeshi
(cid:0)
(cid:0)
(cid:0)
Any other Asian background (specify if you wish) ..............................................
1.
2.
White
Asian
3.
Black
Caribbean
African
(cid:0)
(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) .............................................
AVOCET TRUST Head Office: 60-62 Clarence Street, Hull, East Yorkshire. HU9 1DN
t: 01482 329 226 f: 01482 329 337 e: info@avocettrust.co.uk w: www.avocettrust.co.uk