Application form

The Rehabilitation of Offenders Act helps rehabilitated ex-offenders back into work by allowing them not to declare criminal convictions after the rehabilitation period set by the Court has elapsed and the convictions become "spent". During the rehabilitation period, convictions are referred to as "unspent" convictions and must be declared to employers. Before you can be considered for appointment with the NHS we need to be satisfied about your character and suitability. The NHS aims to promote equality of opportunity and is committed to treating all applicants for positions fairly and on merit regardless of race, gender, marital status, religion or belief, disability, sexual orientation and age. The NHS undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared. If you are applying for a post involving access to persons in receipt of health services, your offer of employment may be subject to a satisfactory disclosure from the Criminal Records Bureau. Failure to reveal information relating to any convictions could lead to withdrawal of an offer of employment. Anyone applying for a position which involves a regulated activity and certain controlled activity from 12 October 2009 will require an enhanced Criminal Records Bureau check and that disclosure will, where appropriate to the role, include information against the Independent Safeguarding Authority barred lists for working with children or working with adults or both.

In order to protect certain vulnerable groups within society, there are a number of posts within the NHS that are exempt from the provisions of the Rehabilitation of Offenders Act 1974. As the post you have applied for falls within this category, it will be exempt from the provisions of the Rehabilitation of Offenders Act by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Applicants for such posts are not entitled to withhold any information about convictions or other relevant criminal record information which for other purposes are "spent" under the provisions of the Act. If you are successful with this application, any failure to disclose such information could result in dismissal or disciplinary action. Any information provided will be confidential and will be considered only in relation to posts to which the Order applies. From 12 October 2009 under the terms of the Safeguarding Vulnerable Groups Act (2006), all positions involving regulated and certain controlled activity with children and vulnerable adults and which are carried out frequently, intensively or overnight will require an enhanced Criminal Records Bureau (CRB) check. Where appropriate to the role, the CRB disclosure will include information against the Independent Safeguarding Authority barred lists for working with children and/or vulnerable adults.

The information in this form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details.

It is important that we are aware of your current health status as well as providing details regarding your emergency contact person. In cases of emergency, we will make contact if any issues should arise during your time volunteering with us. If you answer YES to any of the questions below, the Voluntary Service Manager/ Coordinator will refer you to Occupational Health. The nurse will send you an appointment or discuss the problem over the phone as appropriate.

In this section please give your reasons for applying for this role and additional information which shows how you match the volunteer specification (on the role descriptor). This can include relevant skills, knowledge, experience, voluntary activities and training etc.

Please state the names and contact details of the people who have agreed to supply references covering a minimum of three years employment/training. If you are or have been employed, these should include your two most recent employers, your line manager or someone in a position of responsibility who can comment on your work experience, competence, personal qualities and suitability for the post. If you are a student please provide contact details of a teacher at your school, college or university. If you have not been in employment for a considerable amount of time but have had previous employment, then you should seek one reference from your last known employer and a personal reference from a person of some standing within your community i.e. doctor, solicitor, MP etc. Where it is not possible to obtain any employer reference at all then please obtain two personal references. Where no personal reference can be obtained then references should be sought from personal acquaintances not related to or involved in any financial arrangement with you. Please ensure that you provide full contact details. Please note referees may be contacted prior to informal interview.

Follow the link to complete the monitoring information questionnaire.
The information collected will only be used for monitoring purposes in an anonymised format and will help the organisation analyse the profile and make up of applicants and appointees to volunteer roles. NHS organisations recognise and actively promote the benefits of a diverse volunteer workforce and are committed to treating all employees with dignity and respect regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. We therefore welcome applications from all sections of the community.