Behaviour Technician

Job Role*

Support Worker
Supported Living Worker
Waking Night
Senior Support Worker
Behaviour Technician
Relief Support Worker
Deputy Manager
Registered Manager
Behaviour Analyst
Associate Behaviour Analyst

Your Details

Name*

Prefix First Last

Pronouns*

Preferred Name

Email*

Enter Email Confirm Email

Work Tel.

Mobile Tel.*

Address*

Street Address Address Line 2 City County Post Code Country

Do you have a driving license?*

Yes
No

Do you have any endorsements?*

Yes
No

Please provide details of endorsements:*

Do you have access to a vehicle to travel to work?*

Yes
No

Do you have a current right to work in the UK?*

Yes
No

Please provide details:*

Do you consider yourself to have a disability?*

Yes
No

Please tell us if there are any reasonable adjustments we can make to assist you in the application or with our recruitment process:

Please tell us how you heard about this position*

Do you have any family or household members who work for Green Light?*

Yes
No

Have you previously been employed by Green Light or applied to Green Light?*

Yes
No

Preferred working arrangement*

Full Time
Part time

Please give details about how many hours per week (e.g. 20, 30 hours):*

Will this be your only employment?*

Yes
No

Education and Qualifications*

Please provide your education history here, including ALL qualifications, both academic and vocational, and any ongoing study:

Use the icon to add a new line.

Schools/Colleges/University	Qualification (e.g. GCSE, care certificate)	Grade	Month/year

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Education and Qualifications

Please provide your education history here, including ALL qualifications, both academic and vocational, and any ongoing study: Use the icon to add a new line.

Employment History

Please note due to our requirements under the Health & Social Care Act, we require full & unequivocal employment history. This must date back to when you left full time education, include months & years and ensure that any gaps are accounted for.

Are you currently in employment?*

Yes
No

Current Employer's Details

Employer’s Name*

Employers Address*

Street Address Address Line 2 City County Post Code Country

Job Title*

Salary*

Employed From:*

Notice period:*

Description of role*

Reason for leaving*

Previous Employment*

Please include all employment and voluntary work since leaving school, starting with your most recent employment and working back. Please ensure all time periods are accounted for including any gaps (e.g. travelling, maternity leave, unemployment etc).

Use the icon to add a new line.

Employer Name	Job Title	Start Date (month and year)	End Date (month and year)	Responsibilities	Reason for Leaving

Personal skills, values and development

Please tell us about any courses, professional memberships, voluntary work, responsibilities, skills, experience and strengths you have obtained that you consider relevant, with outcomes where applicable:*

Please tell us about any other occasions where you have demonstrated the values and behaviours outlined in the Job Description for this position:*

Please tell us about your personal beliefs, values and guiding principles and how will they help us in our mission:*

References

Please provide details of two referees who can comment on your suitability for this position.

Your first referee must be your current employer (or most recent employer if you are not currently employed), or your teacher/tutor if you are a school/college leaver. Your second referee can be either an employment or character reference (however please note that we cannot accept references from family members).

We will only take up references if an offer of employment is made and accepted, and will ask for your consent before we do so. Any offer of employment will be conditional upon receipt of satisfactory references.

Reference 1

Name (first & last name)*

Position*

Organisation name and address:*

Street Address Address Line 2 City County Post Code Country

Email*

Telephone*

Reference 2

Name (first & last name)*

Position*

Organisation name and address:*

Street Address Address Line 2 City County Post Code Country

Email*

Telephone*

Criminal Records

Policy statement on recruiting applicants with criminal records

The post you are applying for is ‘exempt’ from the Rehabilitation of Offenders Act 1974 and therefore you are required to declare any convictions, cautions, reprimands and final warnings that are not "protected" (i.e. filtered out) as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013). For further information on filtering please refer to Nacro guidance and DBS website.

We recognise the contribution that former or ex-offenders can make as employees and volunteers and welcome applications from them. A person’s criminal record will not, in itself, debar that person from being appointed to this post. Any information given will be treated in the strictest confidence. Suitable applicants will not be refused posts because of offences which are not relevant to the role and which do not make them a risk in the role for which they are applying

All cases will be examined on an individual basis, taking the following into consideration:

Whether the conviction is relevant to the position applied for.
The seriousness of any offence revealed.
The age of the applicant at the time of the offence(s).
The length of time since the offence(s) occurred.
Whether the applicant has a pattern of offending behaviour.
The circumstances surrounding the offence(s), and the explanation(s) offered by the person concerned.
Whether the applicant's circumstances have changed since the offending behaviour.

Failure to disclose all convictions, cautions, reprimands or final warnings that are not “protected” could result in disciplinary proceedings or dismissal.

Criminal Record Declaration*

Do you have any convictions, cautions, reprimands or final warnings which are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?

Yes
No

You now have two options on how to disclose your criminal record.*

Provide details here
Disclose details separately

Please provide details of your criminal record:*

I have attached details of my conviction separately:*

You can disclose your record under separate cover provided that you indicate YES and attach the details in a separate email. The email should be marked CONFIDENTIAL in the title, and state your name and the details of the post, and be addressed to [email protected] .

Yes
No

Declaration*

I declare that:

I confirm that the information in this application form is complete and correct to the best of my knowledge, and that any untrue or misleading information will give Green LIght PBS Ltd the right to terminate any employment offered.
I have read the privacy policy and confirm my explicit consent within the meaning of the General Data Protection Regulations 2018 for Green Light PBS Ltd to process my personal information which may include electronic storage of my personal information. I understand that my information will be held securely and confidentially and if I wish to gain access to my information I can do so by requesting it in writing.
I understand that the declaration of a criminal record will not necessarily prevent me from being offered this role at Green Light PBS Ltd.
I understand that any offer of employment is subject to Green Light PBS Ltd being satisfied with the results of pre-employment checks including references, eligibility to work in the UK, criminal convictions, probationary period and medical screening (in line with the operation of the Equality Act 2010).

I confirm that I have read and understood this declaration

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Job Application

Your Details

Employment History

Current Employer's Details

Personal skills, values and development

References

Reference 1

Reference 2

Criminal Records