Name:

Post applying for:

Male/female:

Address:

Nationality:

Date of birth:

E-male address:

Telephone no(s):

Employment (current/most recent first) and reason for leaving:

Education and Training (current/most recent first):

Any training courses in progress:

Please supply the names and contact details of at least two referees who can comment on your suitability for this position. One should be your current or most recent employer. References will not be accepted from relations or people who only know you as a friend:

The position for which you are applying involves working with children and is exempt from the Rehabilitation of Offenders Act 1974 and all subsequent amendments (England and Wales).

For this position you are not entitled to withhold information about police cautions, “bindovers” or criminal convictions including any that would otherwise be considered “spent” under the Act.

Declaration

For the purpose of the Data Protection Act 1998, I consent to the information contained in this form, and any information received by or on behalf of Ryan’s Childcare Limited relating to the subject, being processed by them in administering the recruitment process. I declare that the information I have given on this form is complete and accurate and that I am not banned or disqualified from working with children nor subject to any sanctions or conditions on my employment imposed by the independent Safeguarding Authority, the Secretary of State or a regulatory body. I understand that to knowingly give false information, could result in the withdrawal of any offer of appointment, or my dismissal at any time in the future, and possible criminal prosecution.

Have you ever been convicted of any offence or “bound-over” or given a caution?

If yes please give details below. All potential employees of Ryan’s Childcare Limited will be required to undergo an Enhanced CRB check and any employment will be subject to a satisfactory check being received.