PLEASE COMPLETE IN BLOCK CAPITALS

Personal Details
Title: Mr.
Forenames: Caleb
Surname: Price-Collier
Any Previous Names:
National Insurance PG 99 58 92 A
Number:
Mobile: 07368237458
Telephone:
Landline: 07368237458
Email Address: Calebtpc@outlook.com
House 12
Address: Name/Number:
Street: Paddock Court
Town: Telford
City:
County: Shropshire
Postcode: TF4 3PS

1
 Details of Next of Kin 1
Name: Claire Price

Relationship to Mother
Employee:
Contact Numbers:
Mobile Number: 07815716871

Landline Number: 07815716871

Address:
House 12
Name/Number:
Street: Paddock Court

Town: Telford

City:

County: Shropshire

Postcode: TF4 3PS

Details of Next of Kin 2

Name: none

Relationship to
Employee:
Contact Numbers:
Mobile Number:

Landline Number:
Address:
House
Name/Number:
Street:

Town:

City:

County:

Postcode:

Academic Qualifications

2
 Location of Study Qualifications: Date (To and from):
GCSE English (B) 2012 - 2017
Telford Langley
School

“ GCSE Maths (D) “

“ GCSE Science (C) “

“ BTEC Sport (Merit) "

“ BTEC IT (Pass) “

Professional and Clinical Qualifications

(Original certificates must be provided to evidence qualifications)
Location of Study Qualifications Date (To and from,
Month and Year)

Skills and Experience

(Please provide a statement in support of your application such as any
skills, experience, or achievements you think make you a suitable
candidate for this role)

3
I have worked in challenging behaviour units within Telford for
companies such as CareTech, Eden Futures, Swanton Care, and
Creative Support.

When working these jobs, I would be challenged with defusing

situations from heightened behaviours from service users, so I have
been able to effectively work in these conditions.

I have also worked as a security supervisor and now further

understand how to effectively defuse situations from my time working
at IPM. Working with IPM has also made me more effective at
communicating and understanding behaviours before they happen.

4
Current Employment (or last employment if not currently employed)

Employer
Name: IPM Group
Employer Shefield
Address

Position held: Security Supervisor

Start date: End date: (if DEC 2022

DEC 2021 applicable)
Brief description I would be responsible with all staff supplied my ipm at stadiums
such as Stoke City, Crewe Alex, Coventry City, Derby, and
of current Scunthorpe.
duties,
responsibilities I would give a brief before the game after making sure all staff have
and signed in and have appropriate uniform, detailing the current terrorist
threat levels and any risks groups detailed in the supervisor's brief.
achievements: I would then position my staff around the stadium and do periodic
welfare checks on the staff.
I would then submit the signing sheets and a count of staff into the
supervisors group chat so they can be processed.
I would have constant Radio Comms with control in any event of an
incident.
At the end of the game, I would give a debrief before relieving staff of
their duties and then when I get home, I would have to write up a
post-match report that’s sent to area managers for review

Reason for
Travel issues and payment issues
leaving:

5
What is your none
current
contractual
notice period?

Previous Employment History

(since leaving secondary education)
Please provide all employment in reverse date order starting with the
most recent

Company Name Position Held Dates Reason for

(To and from – Leaving
Month and
Year)
IPM Supervisor DEC 2021 – Travel Issues
DEC 2022
Eden Futures Support Worker July 2021 – Oct Change of Job
2021
Creative Support Worker Nov 2020 – Jan Got COVID
Support 2021
CareTech Support Worker Feb 2020 – Nov New Challenge
(Nights) 2020
Swanton Care Support worker Jun 2019 – Feb Couldn’t offer
(Nights) 2020 full time

6
 Gaps in Employment
Please indicate and explain any gaps in employment since first leaving
secondary education. Include specific dates and be sure to account for
all gaps, whatever their length.

Dates from: Dates to: Reason for gap

Oct 2021 Dec 2022 Looking for employment

Jan 2021 July 2021 Waiting for DBS and Ref

Community, Voluntary or Intern Experience

Company Name Position Held Dates General Duties
(To and from –
Month and
Year)

7
 Driving licence
Current driving licence? Yes If yes, type of licence
Provisonal

Any current endorsements? No. If yes, give details

Any motoring prosecutions pending? No. If yes, give details

Membership of Professional Associations or Statutory

Body

Organisation Name Level of Registration

Membership/Role/Registration Date
No. (if applicable)

Are you subject to Yes No

any conditions or
prohibitions
placed on you by
any statutory body in
the UK?
*If Yes – please
provide details in a
sealed envelope and
attach with this form
(please highlight yes or no)

8
 Professional References
Please provide full names and addresses of two professional
employment references. Your first reference must be from your current
or previous place of work and addressed to your line manager. Nurtured
Future Living Ltd cannot use friends or relatives for any employment
references. Employment references cannot be sent to private or
personal home addresses. You must provide workplace addresses and
the referee must be a higher grade of staff than you yourself, i.e.: your
line manager.

Current or Most Recent Employer

Name: Tim Horne Job Title: Area Manager
How do you Area Manager Company IPM Group
know the Name:
person:
Address: -

Telephone 07415404049 Email: Tim.horne@ipm

Number: group.org
Consent to yes
obtain?
Yes or No:

Second Professional Reference

Name: Julie Bartley Job Title: Area Manager
How do you Area Manager Company IPM Group
know the Name:
person:
Address:
-

Telephone 07527969968 Email: -

Number:
Consent to yes
obtain?
Yes or No:

In agreeing to supply the above references, please sign to state your

agreement for Nurtured Future Living to contact any employment,
9
whether paid or voluntary, where you have worked with children, young
people, and vulnerable adults.

Signature: Caleb Price-Collier

Care/Young People Related Reference

Name: James Holbrook Job Title: Service
Manager
How do you Service Company Eden Futures
know the Manager Name:
person:
Address: Pear Tree Apartments,
Ketley

Telephone - Email: James.Holbrook

Number: @edenfutures.o
rg
Consent to Yes
obtain?
Yes or No:

Care/Young People Related Reference

Name: Catherine lewis Job Title: Service
Manager
How do you Service Company Creative
know the Manager Name: Support
person:
Address: 119 Doseley Road,
Doseley

Telephone - Email: Catherine.Lewis

Number: @creativesuppo
rt.org
Consent to yes
obtain?
10
 Yes or No:

Disclosure & Barring Services Check

This employment is not exempt from the provisions of the Rehabilitation
of Offenders Act 1974, you are not therefore entitled to withhold
information requested by the company about any previous conviction in
this country or abroad you may have, even if in other circumstances
these would appear spent. I confirm the that the information I have
given is true. I understand that if information given on the application
form is found to be false, it may result in disciplinary action which could
include dismissal.
Declaration under the Protection of Freedoms Act 2012
The post for which you are applying is a ‘regulated activity’ within the
meaning of Part 5 Chapter 1 of the Protection of Freedoms Act 2012 and
it is a criminal offence for a ‘barred person’ to apply to work in a
regulated activity. If you are a barred person you must not proceed with
this job application.
If your application is successful you will be required to co-operate with us
in obtaining a disclosure of criminal convictions and in checking your
barred status with the Disclosure and Barring Service.
Declaration

Are you a barred person? Yes Nox

Do you have any pending/outstanding safeguarding
investigations, disciplinary or suspensions, that might Yes No x
lead you being barred from working with children,
young people or vulnerable adults?
If yes, please give details:

Do you have any criminal convictions/cautions,

reprimands, final warnings or bind overs in the UK or Yes No x
abroad?
(Whether related to work or not)

11
If yes, please give details:

Have you lived and/or worked overseas for a period of Yes No x

3 months or more within the past 5 years?
If yes, please give details:

Have you been the subject of a formal disciplinary Yes No x

sanction or are you in the process of ongoing
disciplinary proceedings in your current employment?
If yes, please give details:

Have you been dismissed from any previous Yes No x

employment?
If yes, please indicate which employment and specify the reasons for
your dismissal (use a separate sheet if necessary):

If you are short-listed for interview the panel will discuss this with you and
your current or previous employer(s).

12
All staff must have an enhanced Child workforce DBS check.
Please provide details of your current DBS check status below:
I require a new DBS check Yes No
I confirm that I am registered with the DBS update
service, have an enhanced Adult & Child or Child Yes No x
workforce certificate and consent to Nurtured Future
Living carrying out a status check on my account

If you state that you are registered with the DBS update service,
please complete the boxes below.
Certificate Date:
Certificate Number:

In order for us to be able to carry out the online DBS check we must see
a copy of the DBS certificate which is registered with the update service.
Should I be offered employment, I accept that I will be required to notify
the company of any changes to my DBS status.
Confidentiality
If you are successful in your application for employment with Nurtured
Future Living:
 All information you see or hear in the course of your duty is
confidential.
 You must not disclose any personal details or information relating
to clients, their medical conditions or information which is deemed
to be commercially sensitive to the organisation.

Data Processing
Personal information collected on this declaration will be processed and
stored in full accordance with the Data Protection Act 1998 and the
General Data Protection Regulation 2018. In line with the legislation
Nurtured Future Living files are kept securely in a safe and secure
location. You understand that any personal detail held by Nurtured
Future Living may be accessed from time to time by inspectors from

13
Ofsted and other regulatory bodies, and designated individuals in line
with contractual obligations.

Working Time Regulations 1998

The European Union has laid down guidelines for all workers, governing
the length of the maximum working week that is safe to work. The
current limit is 48 hours per week. Because you are under no obligation
to accept work offered, you will not be compelled to work more than 48
hours per week, however you may choose to do so.
Please state in the appropriate box to confirm that you have read and
understood the above information.
(If the candidate does with to work more than 48 hours per week, the 48
Hour Opt Form must be completed.)
I DO wish to work more than 48
hrs per week*
Please delete above as appropriate

Employment with Nurtured Future Living

It is Nurtured Future Living policy to employ the most suitably qualified

personnel and to ensure equal opportunity for the advancement of
employee. This includes promotion and training and to prohibit
discrimination against any individual on the basis of race, colour,
ethnicity, nationality, sexual orientation, gender, religion, belief,
pregnancy, marital or civil partnership status, age or disability.

In completion of this application form, I authorise Nurtured Future Living

to obtain references to support this application once an offer has been
made and accepted. I release Nurtured Future Living and submitted
referees from any liability caused by giving and receiving any
information.

I confirm that the information given on this form is to the best of my

knowledge, true and complete and that the provision of any false
statement(s) will be sufficient cause for rejection or if employed,
dismissal.

14
By signing this application form you have confirmed that you have read,
understood, and accepted all of the above.

Sign: Caleb Price-Collier

Print: Caleb Price-Collier

Date: 26/12/2022

How did you hear about Nurtured Future Living? Please provide
details:

On indeed

Availability/Hours?
Could you please confirm what hours a week you are looking for?, e.g
full time, part time? Full Time Hours

Statement on the recruitment and Enhanced DBS

Introduction
As an organisation using the Enhanced Disclosure and Barring Service’s (DBS) checking
service to assess applicants’ suitability for positions of trust, we comply fully with the Code of
Practice and undertake to treat all applicants for positions fairly. We undertake not to
discriminate unfairly against any subject of a DBS check on the basis of a conviction or other
information revealed.
We are committed to the fair treatment of our employees, potential employees and users of
our services, regardless of their offending background.
Policy
We actively promote equality of opportunity for all with the right mix of talent, skills and
potential and welcome applications from a wide range of candidates, including those with

15
criminal records. We select all candidates for interview based on their skills, qualifications
and experience.
A DBS check is only requested after a thorough risk assessment has indicated that one is
both proportionate and relevant to the position concerned. For those positions where a DBS
check is required, all application forms, job adverts and recruitment briefs will contain a
statement that a DBS check will be requested in the event of the individual being offered the
position.
Where a DBS check is to form part of the recruitment process, we encourage all applicants
called for interview to provide details of their criminal record at an early stage in the
application process. We request that this information is sent under separate, confidential
cover, to a designated person within the organisation and we guarantee that this information
will only be seen by those who need to see it as part of the recruitment process.
Unless the nature of the position allows us to ask questions about your entire criminal
record, we only ask about ‘unspent’ convictions as defined in the Rehabilitation of Offenders
Act 1974.
We ensure that all those who are involved in the recruitment process have been suitably
trained to identify and assess the relevance and circumstances of offences. We also ensure
that they have received appropriate guidance and training in the relevant legislation relating
to the employment of ex-offenders, e.g. the Rehabilitation of Offenders Act 1974, and in the
secure handling of “sensitive personal data”, e.g. DBS checks.
At interview, or in a separate discussion, we ensure that an open and measured discussion
takes place on the subject of any offences or other matter that might be relevant to the
position. Failure to reveal information that is directly relevant to the position sought could
lead to withdrawal of an offer of employment.
This policy document is made available to all DBS applicants at the outset of the recruitment
process and we make every subject of a DBS check aware of the existence of the Code of
Practice and make a copy available on request.
We undertake to discuss any matter revealed in a DBS check with the person seeking the
position before withdrawing a conditional offer of employment.

16