application form for link'd in

Application Form

Thank you for registering an interest in applying for a position within our company. Appletree Support is a company that provides care and support for children and young people with disabilities and health care needs.

Appletree Support is an equal opportunities employer and therefore seeks to recruit individuals on the basis of their suitability for a post within caring for children and young people.

Should you have any questions or queries regarding the information in this application pack, or you require further information, please do not hesitate to contact us on 023 9245 5888.

The application process

1. Fully complete the application form, making sure that the criminal declaration form and the application form as a whole are signed.

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014Regulation 17 Good governance

Regulation 19 Fit and proper persons employed

1

2. Please read and sign the enclosed Job description and personal specification and return them together with your completed application form.

3. All positions are subject to two satisfactory references. These references must be from two previous employers.

4. If your application is successful you will be contacted by phone or Letter to ask you to come for an interview.

5. Once your application has been processed, and should it be successful, we will contact you by post to formally offer you a position within our company.

6. Once you have accepted the position you will be asked to attend an induction course, prior to commencement of employment. At this induction Appletree Support will ensure that you are issued with an Employment handbook code of conduct and an ID card.

This Application form is also available in large print, and on tape on request.

Title:- Miss

Forenames(s):Lisa Marie

Surname:Haines

National Insurance number:Please ask

Date of birth:27.05.1994

Any pervious Surname:No.



2

Address:Please ask

Home Telephone number:Unavailable.

Mobile Telephone number:Please ask.

Email Address:[email protected]

Position applied for: Support WorkerDate employment can start: As soon as possible.

Are you a UK resident?

Yes

Do you hold a work permit?

Not needed.

Do you hold a valid driving licence?

Yes

Do you have access to a vehicle?

Yes Do you have business insurance?

No

If yes who is your insurance with:

Admiral Car Insurance

Where did you see this post advertised? My friend recommended your company.

Are you registered or a member with a professional body? No



3

mailto:[email protected]

If yes who are you registered with or a member of? X

Data protection act 1998Information on these forms may be held on computerised records. Strict confidentiality will be observed and disclosures will only be made to payroll and administration purposes.

Entitlement to work in the UKTo comply with Asylum and Immigration Act 1996 (as amended by S. 147 by the Nationality and Immigration and Asylum act 2002) all prospective employees will be required to supply evidence of eligibility to work in the UK. If you are selected for interview you will be provided with further information detailing what documents will be required.

Training and previous experience details. Please tick the relevant boxes if you have experience in this field.

Experience For which length of time

Disability Yes 140 hours (Oct 2014 – March 2015)

Learning Disabilities No

Physical Disabilities Yes 140 hours (Oct 2014 – March 2015)

Palliative care No



4

Autistic Spectrum No

Challenging behaviour Yes 2 full days of shadowing experience

Complex medical needs Yes 140 hours (Oct 2014 – March 2015)

Sensory impairment Yes 140 hours (Oct 2014 – March 2015)

Hours will be flexible and can change from week to week due to client demands. Please give an indication of the amount of hours you are available to be offered work.

10 – 15 hoursAny additional information:

I would like to take on as many hours as possible and I can be flexible during certain evenings and over various weekends too. 15 – 20 hours

20 – 25 hours

25 – 30 hours X



5

Education & Employment History

Please indicate your full employment and education history. If you have not been in employment over any period of time, could you please state the dates and the reason? (E.g. Unemployed, Left to have child, etc.)

Educational History

Name of collage/ university Qualification Date From Date to Level / Grade

University of Portsmouth BSc (Hons) Psychology September 2012 June 2015 Finish with a upper bound 2:1.

Southdowns CollegeA-Levels

A-Levels September 2010 June 2012 Psychology (A) Health and Social Care (B)Sports Studies (B)

The Hayling College GCSES September 2005

July 2010 11 GCSES graded A-C, including Maths, English and Science/additional science.



6

EMPLOYMENT HISTORY

PRESENT EMPLOYMENT: *Present employment is now Apple Tree, please ask me for more details regarding my salary, job description etc.*

Employers Name & Type Job Title Dates Salary Notice RequiredFrom To

JAN HAINES (MOTHER)GEOFF FOOT ESTATE AGENTS7 ELM GROVE,MENGHAM,HAYLING ISLAND, HAMPSHIRE,PO11 9EA.

Part-time Trainee Sales Negotiator

31.05.14

Present £1,200 Per annum

2 weeks or less.

Reason for wishing to leave present employment:To obtain a mental health/psychology related occupation.



7

EMPLOYMENT HISTORY CONTINUED(Enter your most recent employment first. Please include Voluntary & unpaid work. Also account for any breaks in employment).

Employers Name & Type Job Title Date (month & year)

Reason for leaving

From ToCurrently completing voluntary work experience at the Portsmouth University Dog Cognition Centre:Dr Juliane Kaminski Institute of Marine Sciences,Ferry Road,Eastney,Portsmouth, PO4 9LY.

As part of my degree, I completed 140+ hours of voluntary work by shadowing a clinical psychologist: DR GREGORY CLARKEST JAMES MENTAL HEALTH HOPSITALLOCKSWAY ROAD,

Volunteer

Research Assistant

22.05.15

07.10.14

Present

10.03.15

Still currently working in a voluntary position.

140 - 175 hours completed



8

SOUTHSEA,PORTSMOUTH,HAMPSHIRE, PO4 8LD.

MR MIKE BERRY THE OLIVE LEAF PUBLIC HOUSE,48 SEA FRONT,HAYLING ISLAND,HAMPSHIRE,PO11 9HL.

SARAH GASHERTESCO EXPRESS (WEST TOWN),28 STATION ROAD,HAYLING ISLAND,HAMPSHIRE, PO11 0EG.

Public House Staff

Customer Sales assistant

03.08.09

09.07.12

30.05.14

07.10.12

Was looking for a different type of work experience.

Temporary summer position for additional wage and experience. However, was offered a permanent position.



9

Supporting StatementHayling Island – school pupil peer mentor Since my early adolescent years, I had always been interested in helping and supporting people and putting other people’s needs before my own. I found it easy to communicate and gain the trust of friends, colleagues and others around me, even from such an early age. At school, I was appointed the role of a Peer Mentor. This was a position given to students deemed mature and responsible enough to take on the troubles of a fellow pupil, as well as, keeping on track with GCSE revision. Their problems ranged from being bullied or abused at home, to not coping with the stress of exams. From this, I began to develop an interest in counselling and found psychology to be an appropriate pathway. Thus, during May this year (2015), I will be completing my final exam from the University of Portsmouth’s BSc (Hons) course in Psychology. Hoping to finish with a predicted 1st class or high 2:1, will ensure that I am a step closer to achieving my future career goal of becoming an accredited counselling psychologist, where I can continue to help people who are struggling with life’s pressures.

Hayling Island – class room assistant placement Whilst at school, I was given the opportunity to undergo a two week voluntary placement of full-time work at a location of my choice. For this, I chose to work with children at Mill Rythe Infant School as a class room assistant. This involved teaching a ‘year 2’ age group various core subjects such as English, maths and science. Physical education was also important and I was given the opportunity to teach them some various stretches and posture helping exercises. In addition, there was also a lot of encouragement for the children to be creative and therefore given some arts and crafts activities to complete. I believe this experience was good for me as it can it taught me to recognise children’s development needs (e.g. creativity and imaginative play can help brain development, or how a healthy diet and exercising regularly can help muscular and bone development). Encouraging child development is very vital and from this experience I also recognised how it needed to be done correctly, as it could have a huge impact on the children’s present and/or futures. Therefore, I also learnt to understand the pressures and responsibilities that come with helping children and fulfilling their individual needs (with love, care and security being the most important).

Portsmouth - clinical placement experience: As part of my degree’s work placement module, I pursued the job of a research assistant at St James’ mental health hospital in Portsmouth where I would be working with people suffering from mental and physical disabilities. It was here with the chronic pain team, that I gained the invaluable experience of observing group treatment sessions such as mindfulness mediation and tai chi. This allowed me to create a positive rapport with various groups, which was soon noticed by my senior manager Dr (GC). He then allowed for my job role to evolve and gave me further responsibility of telephoning patients to ask for sensitive and personal information (including depression and anxiety referral questionnaire answers, used in tests such as the PHQ-9 and HAD-7). Thus, allowing further development of my confident verbal communication skills and professional telephone manner. Additionally, my key role was to create my own data-base for both South-East Hampshire and Portsmouth patients, in order to observe the differences between pre and post scores from using the service, as well as pre and post scores for individual treatments. To be successful when auditing this amount of confidential data, I had to remain highly organised and have good time management skills. This was especially vital as the data had to be presented by my manager and put before commissioners, in order to keep the full bid that they were awarded. To complete this task, I used MS excel and therefore was able to develop my IT skills further along with good problem solving skills, as manual data input can lead to potential analytical errors. Thus, also ensuring that I remained detail conscious and kept records accurate. Furthermore, liaising with a variety of professionals, from clinical psychologists to physiotherapists, has helped me to perform effectively within a team as we worked together to provide the best service experience for users of the service.



10

Isle of Wight - sexual offender prison experience: During my Easter break, I was able to gain contact with a mental health support worker who counselled various sexual offending prisoners on the Isle of Wight. This gave me the experience of being able to liaise with a variety of professionals, from clinical psychologists to social workers and various prison staff. From this, I learnt the importance of networking and forming a good relationship with fellow members of staff. I was also able to enhance my ability of keeping an open-mind when listening to personal accounts, which could be especially difficult in some cases. As you can see from this, I am eager to learn and develop the way I think about others. I always want to see others in the best possible light and think I would enjoy working with the age group of your cliental and find it interesting to listen to their unique experiences.

Academic profile: I purposely chose a mental health topic for my dissertation, as I knew this was the field of work that I wanted to go into after university. I also chose it because I have a strong passion for encouraging people to seek-help and talk to someone so they do not feel alone. Therefore, I feel like this job opportunity would be more than appropriate for helping me fulfil my drive to encourage and help others to feel good about themselves. The aim of my dissertation was to measure the general public’s attitudes towards mental health problems. Firstly, it focused on people’s own age; to see if that would affect their attitude towards mental health. Secondly, I looked at the association between criminal behaviour and mental health problems to see this affected people’s attitudes. By conducting this research, I found that people aged between 18-29 years old would be more critical of their own (real or imagined) mental health problems, thus making them feel embarrassed and not want to seek-help nor attempt to use services. When completing this task, I believe that it allowed me to practice my already developed problem solving and time management skills, especially when having to analyse data for 195 people and run in-depth statistical tests. Furthermore, in relation to my academic background, during my second year of university we were given the topic of child development to study. For this module, we studied various cultural differences in the upbringing of young children and adolescents. I believe this taught me to uphold a great deal of respect for others, no matter what their differences may entail (race, gender, religious beliefs, culture and status), thus also helping me to practice the maintenance of an open-mind.

Outside interests: Owning two horses is a great responsibility and has given me many opportunities to raise money for various NHS charities such as the ‘Rocky Appeal’ and ‘Hampshire Air Ambulance’ through sponsorship. In total, mum and I have raised over £300.00 by completing sponsored riding events across long distances. I have also recently entered the great south run this year which is will be raising money for the ‘Revitalise’ charity and the Hayling Billy 5 run, which will be raising money for a Portsmouth charity called ‘Cystic Fibrosis Kids’. In relation to my current running of events, most Monday evenings I attend the Hayling College to help coach two groups from the Hayling Island Netball Club, including the seniors aged 11+ and the adults aged 17+. Here we not only delivery skills and fitness practice, but we also teach the players about the importance of maintaining a healthy diet and how to stay safe through appropriate stretching and cool down sessions. Being part of this team and my other team in the Portsmouth league has allowed me to use my own initiative, especially when planning group sessions as a coach. Simultaneously, playing has also allowed me support and encourage other team mates, so that we can improve ourselves and succeed together.

Finally, I hope you’ve enjoyed reading about my experience and would welcome the opportunity to meet with you at interview in order to discuss my application in more depth. Thank you for taking the time to read my supporting statement and I look forwards to hearing from you.



11

References

Please give details of two referees who are able to comment on your honesty and integrity etc. Referees must be your present and last employer.

I have a big list of references that have offered to support my application, please ask for more details.



12

Rehabilitation of Offenders Act

Under the Act, an individual who has had a conviction or (convictions) for an offence, with certain expectation, can be rehabilitated and allowed to treat the conviction as if it had never occurred. A conviction will become ‘spent’ where the individual has not, after a period of time committed another serious offence.

An employer may not under the act, ask a prospective employee if he/she has spent convictions during the recruitment process. The Act makes it unlawful for an employer to discriminate in any way against the employee or to dismiss him/her because of a spent conviction.

ExemptionsA conviction cannot be ‘spent’ under the act if it incurred a sentence of more than two and a half years in prison or was a life sentence, preventative detention or the equivalent for young offenders.In addition the act does not apply when an individual applies for a post which is concerned with the provision of services which involve access to children or young people, older people, people with physical and / or learning disabilities and people with mental health problems.Therefore because of the nature of the work involved, the aforementioned employment is exempt from the provisions of section 4 (2) of theRehabilitation of Offenders Act 1974 by virtue of the rehabilitation of offenders Act 1974 (Exemption) Order 1975.

Applicants are therefore not entitled to withhold information regarding offences which for other purposes are ‘spent’ under the provisions of theAct.

Have you any criminal convictions?If so please give details below

No Signature:

Have you any pending convictions?If so please give details below

No Signature:

Signature: Date:

Failure to disclose any convictions, spent or unspent may result in disciplinary Action.



13

Medical Declaration

This information is used for the purpose of assessing the medical fitness of candidates to carry out the tasks involved with employment. This information is confidential and will only be disclosed to the Recruitment Officer and the Service Manager.

Family Doctor Name

Address

Telephone

Do you or have you suffered from any of the following

Please give details

Back pain / slipped disc No I have none of the medical issues stated below.

Rheumatism No

Heart condition No

Dizzy spells No

Respiratory problems No

Skin disorders No

Any allergies No

Tuberculosis (BCG) No

Hepatitis No

Heart attack No

Mental ill health No

I declare that the above information is a true and accurate account of my medical history.

Signed: Date:



14

Health Declaration

All Applicants are required to complete this health declaration. Any positive answers will not necessarily affect your application.

1. Is your general state of health good?

2. Are you a registered disabled person? If yes please give details and specify and special needs which may relate to your disability.

3. How much time have you lost from work due to illness in the last five years?

4. Please give details of any disease, disorder, hospitalisation or allergies you have experienced in the last three years?:

5. Please give details of medication, drugs or treatment you are currently and/ or regularly receiving?:

6. Please list the vaccinations or immunisations you have had:

I declare that the statements are true and complete to the best of my knowledge and belief. I understand that my General Practitioner may be consulted with my prior consent.

Signed: Date:



15

Application Declaration.

The information contained in this application form is true, correct and complete.I understand that any misrepresentation may invalidate my application/employment arrangements.

I certify that the information contained on this application form is accurate and true. I give my consent to the processing, transfer and disclosure by the Company of all information submitted by me during the recruitment process and throughout any subsequent periods of employment for pre-employment checks, equal opportunities monitoring, payroll operations and training (Data protection Act 1988).

Print Name: Signature:

Date:



16

application form for link'd in

Documents