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Please write below why do you want the job.
Please use this space to tell us how you match
With the things we are looking for
(person specification)
I have worked in a group home for people with learning
difficulties for 3 years now.
Having worked in a team my confidence has grown and I
am ready to work in the community now.
Where I work now not all the people get on all the time,
so I have learnt to listen to everybody and explain to
people why they can’t have things their own way all the time.
I have had training in communication, I can use Makaton.
I think I am firm but fair. For example one of our men
likes to stay up late and then he is tired an irritable the
next day. I have agreed with him that is he stays up late
he will not go out the next day.
In my spare time I like to go ice skating and to the cinema
to see horror films mainly.
I am a keyworker for 6 of the 12 people with learning difficulties who
live in the house. We get on really well, like a family.
Tell us a bit about when you worked in a
team?
I work in a team at Happy Homes. I have
been there a while but other people come
and go.
What are your ambitions?
I want to get some more experience and
then train to be a social worker.
What support might you need to do
the job?
I have a back problem so I cannot lift
anything heavy, but I am fit and have not
taken any time off work with my back.
Can you cook?
YES/NO
Can you drive?
YES/NO
Please give details of any relevant education, training or
qualifications
School, college, or other From To Any
qualification
Fieldhouse School
County College
1995
2001
1999
2002
GCSE English
NVQ level 2
social care
Work – list all the jobs you have had.
Start with the most recent.
You can include unpaid work
Date you
Started
Date
you left
Employer Please tell us
a bit about
what you did
Wages
July 1999
February
2000
Feb 2000
Still there
County
Kitchen Café
Happy
Homes for
people with
learning
difficulties
Waitress
Key worker for
6 people with
learning
difficulties
£5.00 per
hour
£6.00 per
hour
The Rehabilitation of Offenders Act 1974
The job you are applying for is exempt from the Rehabilitation of
Offenders Act. It is a condition of the job that you tell us
about all convictions (spent and unspent, including driving
convictions).
If you don’t tell us, you could be sacked.
All staff will be checked through the Criminal Records Bureau.
If you have no past convictions, cautions or bind-overs and no
pending cases please tick here 
Please give details of any criminal convictions, cautions, bind-
overs or pending cases below -
Asylum and Immigration Act 1996 – Section 8
From 27 January 1997, employers are required to make sure that
all new employees have the right to work in the UK. Please
indicate below your right to work in the UK; applicants short-
listed for interview will be required to provide evidence to
support this statement.
I have the right to work in the UK as defined within Section 8 of
the Asylum and Immigration Act 1996. Please tick one box
YES  NO 
References: One of your referees should be your current or most
recent employer.
Can we contact your referees before interview? YES/NO
NAME: Sharon Stone
POSITION: manager
ADDRESS: Happy Homes
PHONE: 0113 247 7777
NAME: Martin Jarvis
POSITION: teacher
ADDRESS: Fieldhouse School, LEEDS
PHONE: 0113 270 8888
Sample application form   middle
Sample application form   middle

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Sample application form middle

  • 1. Please write below why do you want the job. Please use this space to tell us how you match With the things we are looking for (person specification) I have worked in a group home for people with learning difficulties for 3 years now. Having worked in a team my confidence has grown and I am ready to work in the community now. Where I work now not all the people get on all the time, so I have learnt to listen to everybody and explain to people why they can’t have things their own way all the time. I have had training in communication, I can use Makaton. I think I am firm but fair. For example one of our men likes to stay up late and then he is tired an irritable the next day. I have agreed with him that is he stays up late he will not go out the next day. In my spare time I like to go ice skating and to the cinema to see horror films mainly. I am a keyworker for 6 of the 12 people with learning difficulties who live in the house. We get on really well, like a family. Tell us a bit about when you worked in a team? I work in a team at Happy Homes. I have been there a while but other people come and go. What are your ambitions?
  • 2. I want to get some more experience and then train to be a social worker. What support might you need to do the job? I have a back problem so I cannot lift anything heavy, but I am fit and have not taken any time off work with my back. Can you cook? YES/NO Can you drive? YES/NO
  • 3. Please give details of any relevant education, training or qualifications School, college, or other From To Any qualification Fieldhouse School County College 1995 2001 1999 2002 GCSE English NVQ level 2 social care Work – list all the jobs you have had. Start with the most recent. You can include unpaid work Date you Started Date you left Employer Please tell us a bit about what you did Wages July 1999 February 2000 Feb 2000 Still there County Kitchen Café Happy Homes for people with learning difficulties Waitress Key worker for 6 people with learning difficulties £5.00 per hour £6.00 per hour
  • 4. The Rehabilitation of Offenders Act 1974 The job you are applying for is exempt from the Rehabilitation of Offenders Act. It is a condition of the job that you tell us about all convictions (spent and unspent, including driving convictions). If you don’t tell us, you could be sacked. All staff will be checked through the Criminal Records Bureau. If you have no past convictions, cautions or bind-overs and no pending cases please tick here  Please give details of any criminal convictions, cautions, bind- overs or pending cases below - Asylum and Immigration Act 1996 – Section 8 From 27 January 1997, employers are required to make sure that all new employees have the right to work in the UK. Please indicate below your right to work in the UK; applicants short- listed for interview will be required to provide evidence to support this statement. I have the right to work in the UK as defined within Section 8 of the Asylum and Immigration Act 1996. Please tick one box YES  NO  References: One of your referees should be your current or most recent employer. Can we contact your referees before interview? YES/NO NAME: Sharon Stone POSITION: manager ADDRESS: Happy Homes PHONE: 0113 247 7777 NAME: Martin Jarvis POSITION: teacher ADDRESS: Fieldhouse School, LEEDS PHONE: 0113 270 8888