Emotional Resilience Mentor application
EMPLOYMENT APPLICATION FORM CONFIDENTIAL
Deadline for submissions:
5pm on Monday 22nd June 2020
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Email *
GDPR: Should you be short-listed for interview it is essential that Open Minds can contact you in order to facilitate interview times and further contact about the position you are applying for.  By continuing to complete this form you are giving your consent for Open Minds to hold this information about you and to contact you with specific reference to the vacancy to which you are applying.
I understand that I am applying for a position involving a zero hours contract. This means that even if I am successful in my application, I may not be offered work regularly or at all. I will still have the right to accrue annual leave based on hours I work in this role.  I have the right to refuse work that I am offered. *
PART 1 - PERSONAL DETAILS Personal Information will be treated in confidence and will not be made available for short listing purposes.
Full Name *
Address *
Telephone Number *
DECLARATION I declare that to the best of my knowledge, the information provided on this form is true and complete. I understand that any willful mis-statement or omission may render an offer of employment invalid and lead to termination of employment. Information provided by you will be kept safely and securely in accordance with Open Minds’ Data Protection Policy, and will only be used to enable us to process your application. Ticking yes and submitting the form will act as your signature. *
PART 2 – WORK EXPERIENCE (This includes paid and voluntary work)
I am a counsellor or have an equivalent qualification *
I am or have been a practitioner at Open Minds Counselling Services Ltd. (paid/unpaid) *
ORGANISATION 1) please provide a brief description of the roles you have undertaken in which you have supported vulnerable people *
ORGANISATION 2) please provide a brief description of the roles you have undertaken in which you have supported vulnerable people *
ORGANISATION 3) please provide a brief description of the roles you have undertaken in which you have supported vulnerable people PLEASE INCLUDE YOUR ROLE, ORGANISATION NAME, PAID/UNPAID, REASONS FOR LEAVING *
PART 3 – EDUCATION AND TRAINING
Please provide a brief description of your relevant qualifications i.e. course title, level and year obtained (or to be obtained if in process)   *
PART 4 – JOB SUITABILITY
This role involves providing a package of brief interventions to adults who have made an attempt on their lives within 12 months of their referral date. They are not in psychological crisis and have no substance abuse, anti-social behaviour or Tier  3 conditions.  
Please provide a summary of the ways in which your experiences and personality fit to the role for which you are applying. *
Please tick the criteria below to indicate to what extent you believe you meet them. *
full met
partially met
not met
Significant experience of working 1-2-1 with service users with a range of complex issues
Experience of working with vulnerable individuals or families to make real life positive changes
Experience of working within VCF and public sector organisations
Experience of conducting service user assessments
Experience of working in a therapeutic capacity with vulnerable adults (desirable criteria)
Knowledge of the needs of people who have attempted suicide
Experience working with people who have suicidal ideation
Knowledge of Safeguarding vulnerable adults
Understanding of how to effectively risk assess service users and to identify deteriorating well-being
Experience safeguarding vulnerable adults (desirable criteria)
Experience safeguarding children (desirable criteria)
Proven ability to work on your own initiative and manage a busy workload, identifying potential problems and applying the appropriate solutions
Able to develop and maintain effective and credible relationships with service users
Ability to maintain clear boundaries with staff and service users
Conscientious approach to service delivery
Flexible approach to working hours
Non-judgemental approach to people
An adaptable and positive approach to work
Self-awareness of your own competencies, practical needs and personal resilience, and willing to seek help with these where necessary
PART 5 – CRIMINAL OFFENCES
Have you ever been convicted of a criminal offence? (yes/no) If yes please give details *
PART 6 – REFERENCES Please give names and addresses of two referees to whom we may apply for a reference. One should be your current employer. Both referees must be able to comment on your ability to meet the demands of the job you are applying.
Reference 1 *
Reference 2 *
Part 8: Diversity monitoring form
To ensure that our equal opportunities policy is effective and constantly evaluated, Open Minds invites you to complete this diversity monitoring form. Information volunteered will be treated as being classified and sensitive personal data under the Data Protection Act 1998.
N.B. Any information given is optional and at your sole discretion, in doing so you are also giving your informed consent for Open Minds to use it for the sole purpose of statistical analysis.
Age
Gender Identity
Sexual Orientation
Ethnicity and cultural identity  
Religion or Faith
If you consider yourself to have a disability what is the nature of the disability and what adaptations can we put in place to support you in your role?
If you consider yourself to have a disability what is the nature of the disability and what adaptations can we put in place to support you in your role?
Thank you for your time we will contact you as soon as possible to arrange an interview by telephone or video call if you have been successful.
A copy of your responses will be emailed to the address you provided.
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