323 Roundhay Road, Leeds LS8 4HT

Please complete each of the sections and return completed application forms by email to: hr@care-repair-leeds.org.uk

Personal Details
First Name: Last Name:
Address:
Contact Number:-	Day: Evening:
Email Address:

References
Please give the name and addresses of 2 referees. One must be your present or most recent employer. Family members cannot be referees. Referees will be asked to comment on capability, reliability, timekeeping and absenteeism.
1.	2.
Please state in what capacity you are known by each referee.
1.	2.
Please state if you do not wish us to contact either referee prior to interview.

Employment Details
Are you currently employed?
Name and address of your current or most recent employer:
Date Appointed:
Date of Leaving (if relevant):
Job title and brief description of duties:
Current or most recent salary: Reasons for leaving (if relevant): Current number of hours working: (per week) No. of hours preferred to work: (per week)

Education and Professional Training
From	To	Educational/Training Establishment	Qualifications

Previous Employment
Please list other posts held starting with the most recent, including voluntary or other responsibilities you consider relevant. (No more than 10 years)
From	To	Employer	Position held and reason for leaving.

Additional Information
Full UK Driving Licence:	Yes	No
Access to a Vehicle:	Yes	No

Disclosure of Offences
This post involves dealing with vulnerable people and their information. We would therefore require you to disclose all convictions and cautions, no matter how long ago they occurred and regardless of whether the offences were committed as an adult or as a juvenile.
Do you have any convictions or cautions?	Yes	No
Are you currently subject to any criminal proceedings or police investigations?	Yes	No
If you have answered YES to either or the above questions, please give the details below. *Please note a DBS check will be carried out should you be successful in this role*
Date	Nature of Summons, charge or caution etc.	Court	Sentence or Order

Information in support of your application
Please refer to the employee specification for the post and answer each section. Please give examples and demonstrate clearly that you satisfy all of the essential criteria. Please limit your answers to the box size only.
Experience of working as part of a team

Proven experience of dealing with enquiries using CRM System, providing advice and information, and directing calls where necessary

Experience of monitoring, managing and responding to emails in a timely manner

Examples of when you have had to maintain professional relationships
Proven experience of providing administration support, carrying out telephone assessments and surveys to clients
Ability to manage relationships at all levels and to sustain teamwork approaches
Ability to embrace the continuous development and improvement of administrative processes and systems
Proficient with Microsoft Office programs, including Word, Excel, and databases
Knowledge and understanding of the requirements under the General Data Protection Regulations in handling confidential information
DESIRABLE Experience of working with older, disabled and vulnerable people Ability to collate, analyse and report on data Ability to speak other languages

Declaration
I declare that the information contained in this application form is a true statement.
Signed:	Date:

**See Equal Opportunities Monitoring Information on separate page over

Equal Opportunities Monitoring Information
Care & Repair (Leeds) is committed to employing a workforce that reflects the community we serve. We will take all reasonable steps to ensure that we do not unlawfully discriminate. In order to monitor our progress, we ask you to answer the questions below. Information provided in this section will be used for monitoring purposes only, to monitor and check the fairness of our recruitment, and will play no part at all in the recruitment process. The information you provide will be kept confidential. If you do not wish to complete all or any part of this monitoring form, you do not have to do so.
Where did you see this post advertised?
What is your gender identity:	Woman Trans	Man Other	Non Binary Prefer not to state
Is your gender identity the same as the gender you were assigned at birth?	Yes No Prefer not to state
How do you identify your sexual orientation?	Bisexual Gay Heterosexual Lesbian Other Prefer not to state
Which age bracket do you fall into?	Under 18 18-24 25-34 35-44 45-54 55-64 65-74 75-84 Over 85
What is your ethnic background?	White British	White Irish
White Welsh	White Scottish	White Northern Irish
White English	Other White	Black African
Black Caribbean	Other Black	Bangladeshi
Indian	Pakistani	Chinese
Kashmiri	Other Asian	White & Black Caribbean
White & Black African	White & Asian	Other Mixed Background
Gypsy/Irish Traveller	Arab	Other ethnic group
Do you consider yourself disabled?	Prefer not to state	Yes	No
If “Yes”, which disability or disabilities do you consider yourself to have?	Learning Disability Physical disability or impairment	Mental Health Disability Sensory disability or impairment