This section of the application will be sent for short listing.

Post applied for
Post reference number

Supporting Statement
From the advert and job specification, please demonstrate how you meet the essential and desirable criteria for this post and our values. We will also take into account the information provided in your CV. Please ensure your qualifications and professional memberships are included in your CV or the box below. Please do not include identifiable information in your supporting statement or in your CV. This is an expandable box:

Driving details
If the job you are applying for involves driving, do you hold a current driving licence?	Yes	No
Class (full, provisional, LGV, PSV)
Have you use of a vehicle?	Yes	No

Personal details - this section of the application will be removed for short listing.
Name
Preferred Contact Number
Email address
Please note: your email will be the main method of communication throughout the recruitment process. Please check your email account's spam and junk folders to check for any Vico Homes emails that may be filtered.
Job title

Asylum and Immigration Act 1996
Under the terms of the Asylum and Immigration Act 1996 we can only employ people who are entitled to work in the UK. In observing this Act we will need to see a document which confirms this entitlement before employment starts. It would also be helpful if you confirm entitlement at this stage.
I confirm that I am entitled to work in the UK.	Yes	No

Disability
The Equality Act 2010 defines a disabled person as a person with ‘a physical or mental impairment, which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities’. We ask these questions in accordance with the Equality Act 2010. The information you provide us with will help us to help you through the application and interview process. You no longer have to register your disability.
Do you consider yourself to have a disability?	Yes	No	Prefer not to say
Would the provision of any aids or adaptations assist you in carrying out the duties of this post? Please provide details:
Is there anything we need to know about your disability so that you can have a fair interview? For example, do you need a sign language interpreter, an accessible interview room? Please provide details:
If you have a disability, do you wish to be considered under the guaranteed interview scheme if you meet the criteria as specified in the person specification?	Yes	No
If you do not hold a current driving licence is this due to a disability?	Yes	No
Vico Homes is committed to making reasonable adjustments, therefore if this job requires the jobholder to drive your application will still be considered if you are unable to drive due to a disability.

Criminal Convictions
Are you currently bound over, or do you have any current ‘unspent’ convictions or cautions (including reprimands or warnings) that have been issued by a Court or Court-Martial in the UK or in any other country?
Yes	No
If yes, please provide further details including date and type of offences:

Please disclose any other incidents, factors or other information that may be relevant to determining your suitability to work at Vico Homes (including working with children and vulnerable adults).

Please note: Successful applicants who are offered employment may be subject to a criminal record check from the Disclosure and Barring Service before the appointment is confirmed.

Declaration
I acknowledge that the personal data contained in this application form will be processed for the purposes set out in the Guidance Notes and the Vico Homes Privacy Notice for Job Applicants. I declare that the information I have given in this application is correct to the best of my knowledge. I understand that if I am appointed and it is later discovered that I withheld or falsified relevant information, that disciplinary action may be taken and I may be summarily dismissed. Please note: we will deem the submission of your application form without a signature as confirmation that you comply with the above declaration statement.
Signed	Date