Application Form

Job Reference Number

Title (please specify e.g. Mr)

Your Name (required)

Previous Surname(s)/Family Name(s)

National Insurance Number

Do you need a UK work permit or Visa? If yes, date of expiry

Home telephone (required)

Mobile (required)

Your Email (required)

Your Address

Please answer the following question if the job description/person specification for the job states this as either essential or desirable:

Do you hold a current full driving licence?

Do you currently have endorsements?


If Yes, please give details including expiry date(s)

Do you have access to a vehicle for work purposes?

Have you ever had an application for Motor Insurance either cancelled or refused.

If Yes, please give more information

Education Qualifications - Enter Course and Grades

Membership of Professional Bodies: Nursing/Midwifery

If Applicable. Enter Name, Renewal Date, Membership/Status and Pin Number.

Work History

Please enter dates, name and address of employers and job role. Enter a reason for leaving.

Gaps in work history or experience

Enter dates and reasons.

Supporting Statement

Please set out below any further information which you feel supports your application. In particular, you should provide examples to illustrate how you meet the competencies and experience set out in the Person Specification and Job Description.

Current / Previous Employer References

Current/Previous Employer (1)

Enter Name, Job title, Address, Telephone Number and Dates of Employment.

Current/Previous Employer (2)

Enter Name, Job title, Address, Telephone Number and Dates of Employment.

References; we require references which cover at least 3years of your employment. One reference must be your present or most recent employer. If this is your first job since leaving full time education, your head teacher or further education tutor should be given as referee. Your personal reference must be someone who knows you well.

After interview and prior to any conditional offer of employment, can we contact your current employer (see note below)?

Employment referees will be requested to provide details on, salary, performance, and, where applicable, reasons for leaving. Where relevant, referees will be asked for/ about their knowledge of your work and suitability to work with children, young people and vulnerable adults.

If you are shortlisted, are there any special arrangements we would need to make for your interview and any selection tests? (If Yes, and you are successful in obtaining an interview, we will contact you to discuss your stated needs)?

Where did you see the post advertised

Notice Period: If appointed, how soon could you take up your new post

Do you have any criminal convictions


If yes, please give details below of any criminal convictions, cautions or bind over orders. The post applied for is exempt from the provisions of the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 1986 and therefore you are required to disclose your criminal background, if any. We undertake not to discriminate unfairly on the basis of conviction or other information received. We have a policy statement on the recruitment of ex-offenders a copy is available on request.

For all staff working with children and vulnerable adults a Disclosure Barring System (DBS) current Disclosure check will be required before taking up employment. We have a policy statement on the secure storage, handling, use and retention & disposal of Disclosures and Disclosure information.

Declarations

Data Protection
"I give permission for AJ Case Management Ltd to process and hold on computer the information or data I have supplied or referred to on it, including any information that I consider to be sensitive and personal. I understand and agree that this information will also be held on my personal file, if I am appointed."
"I agree that AJ Case Management Ltd may use the information provided in this application form for equality monitoring purposes, compiling statistics, maintaining other employment records and completing statutory returns as required."
“Should I be unsuccessful in this position I give permission to AJ Case Management to keep my records on file and contact me with information on any future positions unless I state otherwise”

References
"I agree that AJ Case Management Ltd may ask my referees for comments on my suitability for the post and in respect of employment referees request details on my salary, performance, conduct, reasons for leaving and suitability to work with children, young people and Vulnerable adults, where applicable."

Application submission
"In submitting this application form, I confirm that the information I have given is correct and complete and I understand that giving misleading or untruthful statements may result in my dismissal if they become known after my appointment."

Agreement:

 I Agree

Name

Date

For electronically submitted forms you will, if shortlisted, be asked to provide a signature at interview.

Support Worker – Hereford (HR4)

Ref:
AJCM/LAJ/SCH/1117

 Full-time or job share considered
Permanent – 40 hours per week 

An exciting opportunity to support a 23 year old woman, with a brain-injury, living
in the community and attending University.

The successful candidate must be able to demonstrate: 

Previous experience in a similar role or demonstrate a willingness to learn

An interest in sports and physical fitness 

Ability to work as part of a team on a rota, to include weekend working

A full driving licence and access to own vehicle 

Excellent computer, verbal, non-verbal and written communication skills 

A flexible and positive attitude 

A caring disposition and an excellent sense of humour

The ability to motivate and enable 

This role does not involve personal care

This is a fantastic opportunity to work with a quality Case Management company
which values long term personal and professional development and treats staff
with respect. In addition, your commitment and attention will be rewarded with
excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an
enhanced DBS disclosure being obtained.

Closing Date: 15.12.2017

Part-Time Support Worker – Telford (TF3)

Ref:
AJCM/LAJ/GOM/1117

Permanent – 11 hours per week

An exciting opportunity to support a lady, in her 30s, with a brain-injury, with day to
day activities including social and leisure activities

The successful candidate must be able to demonstrate: 

Previous experience in a similar role or demonstrate a willingness to learn 

An interest in supporting, and finding, a range of different community-based
activities 

Ability to work flexibly as part of a team, on a rota 

A full driving licence and access to a vehicle 

Excellent computer, verbal, non-verbal and written communication skills 

A flexible, positive attitude and patient nature 

A caring and friendly disposition and a sense of humour 

The ability to motivate and enable the client and to apply strategies as
advised by therapists 

An understanding of the impact of mental health issues 

This role does not involve personal care

This is a fantastic opportunity to work with a quality case management
company which values long term personal and professional development and
treats staff with respect. In addition, your commitment and attention will be
rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an
enhanced DBS disclosure being obtained.

Closing Date: 14.12.2017

Support Worker - Northwich, Barnton

Support Worker – Northwich, Barnton

Ref:
AJCM/SB/TRK/1117

Permanent – 33 hours per week

Are you caring, outgoing and looking to assist a child through their rehabilitation journey?

An exciting opportunity to support a child with a brain injury at home and in the community, who enjoys swimming, trampolining and horse riding and being part of the community.

The successful candidate must be able to demonstrate:

Previous experience in a similar role or demonstrate a willingness to learn

A full driving licence

Excellent computer, verbal, non-verbal and written communication skills

A flexible and positive attitude

A caring disposition and an excellent sense of humour

The ability to motivate and enable

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development and treats staff with respect.

In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 12.12.2017

Part-Time Support Worker – Sutton Coldfield (B74)

Ref: AJCM/LAJ/TP/1117

Permanent – 9 hours per week in term-time, 20 hours per week in school holidays

(Term-time hours needed on Thursday and Saturday afternoons, holiday hours are negotiable)

An exciting opportunity to support an 18 year old young man, with cerebral palsy, with social and leisure activities

He has a great sense of humour, a sense of adventure and is keen to try new things

The successful candidate must be able to demonstrate:

 Previous experience in a similar care role

 A proactive, positive attitude and patient nature

 An interest in supporting a range of activities, including finding new activities to try

 A flexible approach, the role includes weekend working

 A full driving licence, and a willingness to drive the client’s adapted vehicle

 Excellent computer, verbal, non-verbal and written communication skills

 A caring and friendly disposition and an excellent sense of humour

The ability to motivate and enable through support and care

This is a fantastic opportunity to work with a friendly and welcoming family and a Case Management company which values long term personal and

professional development and treats staff with respect. In addition, your commitment and attention will be rewarded with good rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 5.12.2017

Support Worker – LE16

Ref:

AJCM/LAJ/HJW/1017

I’m a happy, easy-going 9 year old boy with additional needs. I need some more support, especially at weekends and in school holidays. I like people who are enthusiastic and will help me try new things. I enjoy going to Cubs, trampolining and horse-riding.

The successful candidate must be able to demonstrate:

 Previous experience in a similar role or demonstrate a willingness to learn

Ability to work as part of a team on a rota to include days, evenings and weekend working 

A full driving licence

 Excellent computer, verbal, non-verbal and written communication skills

 A flexible and positive attitude

 A caring disposition and sense of humour

 The ability to motivate and enable

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development and treats staff with respect. In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to satisfactory references and an enhanced DBS disclosure being obtained.

Closing Date: 04.12.2017

Personal Assistant – Bedworth

Ref:

AJCM/WR/PW/PA1017

Temporary to cover maternity leave– 35 hours per week

An exciting opportunity to support a brain-injured person in the community. The post involves supporting a client who lives independently in his own accommodation to enhance his life skills and social activity.

The successful candidate must be able to demonstrate:

 Previous experience in a similar role or demonstrate a willingness to learn

 Driving licence

 Excellent computer, verbal, non-verbal and written communication skills

 A flexible and positive attitude

 A caring disposition and an excellent sense of humour

 The ability to motivate and enable

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development and treats staff with respect.

In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 30/11/2017

Therapy Assistant - Coventry

Ref: AJCM/AJM/SRH/1017

35 hours per week, Term Time Only

This is an exciting opportunity to provide therapeutic support and rehabilitation to a 5-year old `girl with cerebral palsy within a specialist school setting in

Coventry.

The role is term-time only and will involve supporting the client to complete her therapy programmes in a safe and consistent way, and to

feedback to the family and wider team.

Full time or job share considered.Relevant experience is essential. Experience of working with children with physical, cognitive, communication and/or behavioural problems desirable. Personal care required, therefore this role will be open to females only.

*For genuine occupational requirement reasons we are looking to appoint a female only for this post (exemption under the Equality Act 2010 Part 1 Schedule 9).

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development

and treats staff with respect.

In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 4th December 2017

Support Worker - Great Wyrley

Ref: AJCM/AJM/SRH/1017

35 hours per week, Term Time Only

This is an exciting opportunity to provide therapeutic support and rehabilitation to a 5-year old `girl with cerebral palsy within a specialist school setting in

Coventry.

The role is term-time only and will involve supporting the client to complete her therapy programmes in a safe and consistent way, and to

feedback to the family and wider team.

Full time or job share considered.Relevant experience is essential. Experience of working with children with physical, cognitive, communication and/or behavioural problems desirable. Personal care required, therefore this role will be open to females only.

*For genuine occupational requirement reasons we are looking to appoint a female only for this post (exemption under the Equality Act 2010 Part 1 Schedule 9).

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development

and treats staff with respect.

In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 4th December 2017

Support Worker - Great Wyrley

Ref: AJCM/HB/LS/0917

Permanent 35 hours per week

An exciting opportunity to support a young man (13 years old) who has cerebral palsy in the community

The successful candidate must be able to demonstrate:

 Previous experience in a similar role or demonstrate a willingness to learn

Ability to work as part of a team on a rota to include days, nights and weekend working

Driver preferred

 Excellent computer, verbal, non-verbal and written communication skills

 A flexible and positive attitude

 A caring disposition and an excellent sense of humour

The ability to motivate and enable

 Ability to work in a family home with pets

This is a fantastic opportunity to work with a quality case management company which values long term personal and professional development and treats staff with respect. In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please note that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Closing Date: 12th October 2017

Female Therapy Assistant – Coventry

35 hours per week, term time only.

This is an exciting opportunity to provide therapeutic support and rehabilitation to a 5-year old girl with cerebral palsy within a specialist school setting in Coventry.

The role is term-time only and will involve supporting the client to complete her therapy programmes in a safe and consistent way, and to feedback to the family and wider team.

Full time or job share considered. Relevant experience is essential.

Experience of working with children with physical, cognitive, communication and/or behavioural problems desirable. Personal care for this role is also required.



*For genuine occupational requirement reasons we are looking to appoint a female
only for this post (exemption under the Equality Act 2010 Part 1 Schedule 9)

Support Worker – Equestrian / Wolverhampton

Ref: AJCM/LAJ/CB/0717

An opportunity has arisen to become a support worker for a 16 year old girl, who suffered a brain injury in 2012. Our client has no physical difficulties and this role is about increasing her confidence, by supporting her socially and providing support with the care of her horses and riding.
10 hours are available term time and 25 hours during college holidays
Interested?

Personal Assistant – Stoke on Trent


Job Ref: AJCM/AJM/SK/0517

Permanent position with full and part time hours available

An exciting opportunity to support a young male adult with a brain injury in the community. The post involves supporting him to live independently in his own accommodation to enhance his life skills and social activity.

The successful candidate must be able to demonstrate:

Previous experience in a similar role or demonstrate a willingness to learn

 Driving licence and use of a car for work purposes

 No personal care required

 Excellent computer, verbal, non-verbal and written communication skills

 A flexible and positive attitude

 A caring disposition and an excellent sense of humour

 The ability to motivate and enable

This is a fantastic opportunity to work with a quality case management company which values long term and professional development and treats staff with respect.

In addition, your commitment and attention will be rewarded with excellent rates of pay and a great deal of job satisfaction.

Please not that employment will be subject to excellent references and an enhanced DBS disclosure being obtained.

Contact Us

Tel: 01902 244 170

Email: ajrecruitment@ajcasemanagement.com

AJ Case Management Ltd

James House,
Newport Road,
Albrighton
WV7 3FA