Application for Work

Emergency Contact

Please complete the entries below clearly stating your employment history for the last 2 years. This must include employment or study both in the UK or overseas.

Please note that all periods must be accounted for including maternity leave, unemployment, visits to other countries, study etc. Please ensure that you write the start month and finish month and year for each job/study. Please only provide company or organisation email address. No personal email addresses will be accepted.

• Please provide as much detail as you can. We will need to contact these organisations to verify your work history.
• Please start with the most recent first, and work chronologically backwards.
• Please don't leave the 'date finished' field blank if still employed in this role.

Please provide at least 2 work history references.
Please sign at the bottom to verify your work history and to give consent for us to contact the listed workplaces.

Add another career entry

Please only enter your childcare related qualifications into the fields below. Note, if unqualified please state 'unqualified'

Add another qualification

Please give the dates of training such as:

The post that you have applied for is excepted from the Rehabilitation of Offenders Act 1974, which means all convictions, cautions, reprimands, spent convictions and final warnings on your criminal record need to be disclosed. Please be aware that an Enhanced Disclosure will be sought through the Criminal Records Bureau in the event of a successful application.

Only relevant convictions and other relevant information will be taken into account so disclosure need not necessarily be a bar to obtaining this position.

Have you ever been convicted by the courts or cautioned, reprimanded or given a final warning by the police? *

If yes, please specify details

Add another offence

Police Enquiries

If yes, please specify details

Add another enquiry

Name History

Have you used any other first or last names? If so, please specify.

Please note - It is important that you do not leave any date gaps between name changes.

Add another name

5 Year Address History

Have you changed address in the last 5 years.

Please note - It is important that you do not leave any date gaps between address changes.

Add another address

JBD are required to ask all employees to make a declaration about whether they are a disqualified person under the Childcare (Disqualification) Regulations 2009.

A person may be disqualified under the regulations because:

1. They have certain orders, directions or restrictions placed upon them in relation to children or childcare
2. They have been cautioned or convicted of certain offences
3. They live or work in the same household as someone who is disqualified

You are required to complete the declaration below confirming that you are not disqualified under these regulations.

Section 1 - Orders or other restrictions

Section 2 - Specified and Statutory Offences

Have you ever been cautioned, reprimanded, given a warning for or convicted of:

Section 3 - Disqualification by Association

Section 4 - Provision of Information

If you have answered YES to any of the questions above you should provide details below in respect of yourself, or where relevant the member of your household: (You may provide this information separately if you wish, but you must provide this without delay).

Section 5 - Declaration

Please note - if you do not submit your details with your first timesheet there will be a delay in your payment

Your Present Circumstances

Read all the following statements carefully and select the one box that applies to you.

This is my first job since last 6 April and I have not been receiving taxable Jobseeker's Allowance, Employment and Support Allowance or taxable Incapacity Benefit or a state or occupational pension.

This is now my only job, but since last 6 April I have had another job, or have received taxable Jobseeker's Allowance, Employment and Support Allowance or taxable Incapacity Benefit. I do now receive a state or occupational pension.

I have another job or receive a state or occupational pension.

Student Loan Declaration

I left a course of Higher Education before last 6 April and received my first UK Student Load instalment on or after 1 September 1998 and have not fully repaid my Student Load. (Do not check the box if you are repaying your UK Student Load by agreement with the UK Student Loans Company to make monthly payments through your bank of building society account.)

Current law states that JBD Recruitment must limit your work to 48 hours per week unless you declare otherwise. You may refuse work at any time and will never be asked to work over 48 hours per week. However you may do so if you choose that the limit shall not apply to you. JBD Recruitment wishes to have an agreement with you.

It proposes an agreement (which will apply until terminated by notice) on the basis that:

1. The 48-hour limit on average weekly working time will not apply to you;
2. You may terminate the agreement (so that the 48-hour time limit would apply to you) by giving the person at the Company to whom you usually report 4 weeks written notice.

Under the Regulations, the Company must keep records relating to your working time.
This is the case whether or not you reach an agreement with the company about waiving time limits.

Please read the statement below and delete as appropriate:
I agree to opt out of the limit of 48 hours per week *

The following questions on health and disability are asked in order to find out your needs in terms of reasonable adjustments to access our recruitment service and to find out your needs in order to perform the job or position sought.

Do you have any health issues or a disability relevant to the position or role you seek? *

Are you taking medication?

If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc?

Please upload an up to date CV - simply browse and choose your recent CV then press upload.

Since 1st October 2011, have you worked for the same nursery, school or setting for more than 12 weeks without taking a break of at least 6 weeks?

If yes, please state the agency, nursery/school/setting name, dates (mm/yyyy) and duration of placements.