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Your contact details

Are you entitled to work in the UK?

Do you require a visa?

Tell us about you

Work experience

Education

Secondary Education

Higher Education

Professional Qualifications

Disclosure and Baring Check

Do you have any criminal convictions, reprimands or cautions?

References

Employment reference 1

Employment reference 2

Educational reference

Personal reference

Equality and Diversity Information

Disclaimer- This information is recorded and used for reporting purpose only and will not be used as part of the selection process.

If yes

Are there any arrangements we can make for your interview?

Declaration

I consent to Leading Lives using the information provided to carry out checks from this application form and understand that this will be used when making a decision about my suitability to work with or be in regular contact with vulnerable adults.

I understand that Leading Lives will share any information they obtain about me with other organisations where the law requires them to, including where information raises concerns of an adult/ child protection nature.

To the best of my knowledge, the information I have supplied on this form is correct.

I understand that giving false information or omitting relevant information could disqualify my application and, if I am appointed, could lead to an offer being withdrawn or my dismissal.

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