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Employment Application

Please complete all sections of this form. If you need help filling out this application form or for any phase of the employment process, please contact a member of the Support at Home team on 0151 486 8494

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Stage 1 of 13

The Position

Your Details


From age 11. School, College, University: Please list in chronological order with present or most recent first.

Add Eduction Row


(from school) Please list in chronological order with present or most recent first.*

Add Employment Row

Skills & Experience


Applicants will not be considered unless details of at least 2 personal and 2 professional references provided.

Personal References

Please include at least 2 personal references, do not include relatives.

Add Personal Reference Row

Professional References

(Present or most recent employer)

Please include at least 2 references and supply full addresses including postcode. incomplete applications may not be processed.

Add Professional Reference Row

Maximum average working week

Working time regulations aim to improve health and safety by controlling the hours employees work. Central to the working time regulations is the worker's statutory right to a maximum average working week of 48 hours. Workers (at the moment) can voluntarily agree to opt out of the 48-hour limit.

Diversity Development

Support at Home is committed to the equality of opportunity in employment in accordance with the codes of practice issued by the commission for racial equality, the equal opportunities commission and the code of practice relating to the disability discrimination act. Please answer the questions below, this information is used for monitoring purposes only, and will not be shared with third parties other than in appropriate circumstances.


Support at Home seeks to offer employment opportunities irrespective of physical or mental disabilities wherever possible and will endeavour to make any reasonable adjustments to ensure that disabled people can compete equally with non-disabled people.

If yes please give brief details of the effects of the disability and any assistance you would need:


The position you have applied for is exempt from the provision of section 4 of the rehabilitation of offender’s act 1974, which means that you are not entitled by law to withhold information about any civil or criminal convictions which for other purposes are “spent” under the provisions of the act. In the event of employment, any failure to disclose such convictions may result in dismissal. Any information given will be completely confidential and will be considered only in relation to this application. In view of this would you please answer the following question:


I certify that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief.

I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment.

I understand that any offer of employment will be subject to the receipt of an enhanced criminal record bureau disclosure and four satisfactory references.