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Please indicate which job(s) you would like to apply for:
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Support Worker - ER Service
Support Worker - Egremont
Support Worker, Maryport
Support Worker, Distington
Support Worker, Cleator/Cleator Moor
Support Worker, Carlisle
Support Worker, Workington
Support Worker, Stainburn
Support Worker, Whitehaven
Support Worker, Community Activities
Support Worker, Cafe West Keswick
Support Worker, Childrens
Support Worker, BANK RELIEF
Please specify what kind of position you are interested in i.e. full time/part time
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Full Time
Part Time
Any
Where did you hear about this job?
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Facebook - West House Page
Facebook- CFM Page
Newspaper
Radio
Cumbria Crack
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Current Employee of West House, please state Employee Name below
Employee Name
Name
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First
Last
Email
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Please note that by providing your email, you agree to receive relevant notifications from West House.
Address
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Postcode
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Home telephone number
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Mobile telephone number
Do you drive?
Yes, I drive
No, I don't drive
I'm currently learning to drive
Have you been employed by us before?
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Yes
No
*If Yes Please State Below
Education history
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Please give: the name and location of the school/college or awarding body, dates you studied there, details of examinations taken (include date, level, grade)
Work related training
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Please give date and course/training details.
PRESENT EMPLOYMENT - name and address of present or most recent employer
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If not applicable, please write N/A
Job title
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Salary
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Date started
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Date of leaving (if applicable)
Period of notice required
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Date available to commence employment
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Reason for leaving (if applicable)
Main duties and responsibilities
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PREVIOUS EMPLOYMENT - please give the name and address of previous employers, dates you worked there, job title and brief description of the role and responsibilities, and reason for leaving.
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Please list in date order, most recent first, with no gaps unaccounted for. West House may contact all or any employers you have listed below in order to verify the employment details stated.
Rehabilitation of Offenders Act 1974 - have you ever been convicted of a criminal offence?
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Yes
No
If you answered 'yes' to the question above, please provide details
Immigration, Asylum and Nationality Act 2006 - do you have the right to live and work in the United Kingdom?
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Yes
No
The Immigration, Asylum and Nationality Act 2006 imposes civil and criminal penalties on West House if it employs those who do not have permission to live or work in the United Kingdom. Applicants will be required to provide evidence of their right to work in the United Kingdom if invited to interview.
The role for which you are applying involves substantial moving and bending. Do you have any health problems that might prevent you from satisfying these requirements?
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Yes
No
The information gained from this question will only be used at the pre-employment offer stage to determine if you will be able (in conjunction with any reasonable adjustments) to carry out functions that are intrinsic to the work concerned.
If yes, please give details
The role for which you are applying involves working variable shifts, working at night and at unsociable hours. Do you have any health problems that might prevent you from satisfying these requirements?
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Yes
No
The information gained from this question will only be used at the pre-employment offer stage to determine if you will be able (in conjunction with any reasonable adjustments) to carry out functions that are intrinsic to the work concerned.
If yes, please give details
Are you, to the best of your knowledge, related to any member or employee of West House?
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Yes
No
If yes, please state whether they are a member, management committee member or employee, and give their name, address and your relationship to them.
Please give a description below about what you know about West House your reasons for applying and why you are suitable for the role.
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Please give a description below of any relevant experience you have relating to the job description.
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Referee 1
Name of present employer
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Job title of referee
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Capacity in which known
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Address of referee
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Telephone number
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Email Address - West House will ONLY ask for References by email, therefore it is important that you supply an accurate email address for us to request a reference.
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Can we contact them prior to interview?
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Yes
No
Referee 2
Name of character reference (professional body)
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Job title of referee
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Capacity in which known
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Address of referee
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Telephone number
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Email Address - West House will ONLY ask for References by email, therefore it is important that you supply an accurate email address for us to request a reference.
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Can we contact them prior to interview?
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Yes
No
Any additional information you may wish to include such as any pre booked holidays in the next 6 months.
Declaration
To the best of my knowledge I declare that the information contained in this application form is accurate and correct. I understand and agree that:
a) The provision of false information may result in disqualification from the recruitment process or termination of employment.
b) The information provided on this application may be stored and processed by West House for a period of 6 months for recruitment purposes and if successful the information will be stored on personal file and processed for the purpose of the employment relationship.
c) Where I cannot provide evidence of qualifications and/or suitable references the offer of employment may be rescinded and/or employment terminated.
d) Canvassing of Officers or members of West House directly or indirectly for any appointment will disqualify my application.
e) Depending upon the nature of the post and work I will be undertaking, failure to disclose any convictions spent or otherwise will result in non-appointment or disciplinary action and potential dismissal.
f) Where the post for which I am applying requires me to work with children and/or vulnerable adults I hereby agree to a disclosure being made by the Disclosure & Barring Service about the existence and content of a criminal record spent or otherwise.
g) Should I be short-listed I will be required to provide documentary evidence of my right to live and work in the United Kingdom (see guidance notes).
h) All information contained in this form will be treated as strictly confidential, and used only for recruitment purposes. By supplying information, I am indicating my consent to the information being processed for all employment purposes as defined in the Data Protection Act 1998, and any verification checks that may be made.
I agree to the declaration above (please write name)
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Date
If you do not hear from West House within 28 days of submitting your application form, please consider your application to be unsuccessful.
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