Application form

All fields must be completed

Personal Details



Childcare course full nameGradeDate obtained

Course full nameGradeDate obtained

Current or last employment

Work address

Service period

Previous employment

Service period

Convictions / Disqualifications

To ensure the safety of our customers a DBS check must be completed for all positions. A criminal record will not necessarily be a bar to obtaining a position at KIDACTIVE. If a check is returned and reveals any information, this will be discussed with the applicant. The CEO will make a decision as to whether the offer of employment should be withdrawn.

We would draw your attention to the following statement (taken from the statutory framework for the EYFS).

Disqualification (all registered providers and employees in registered settings)

3.14. A registered provider or a childcare worker may be disqualified from registration 15. In the event of the disqualification of a registered provider, the provider must not continue as an early years provider – nor be directly concerned in the management of such provision. Where a person is disqualified, the provider must not employ that person in connection with early years provision. Where an employer becomes aware of relevant information that may lead to disqualification of an employee, the provider must take appropriate action to ensure the safety of children.

3.15. A registered provider or a childcare worker may also be disqualified because they live in the same household as another person who is disqualified, or because they live in the same household where a disqualified person is employed.

Please provide details below if you or person(s) living in the same household have been convicted of a criminal offence or been the subject of a conditional discharge or probation order:

Reasonable Adjustments / Arrangements for Interview

If you are invited to attend an interview or take up employment and require special arrangements, please give details:


Please give the names and full addresses of 2 people who can verify or confirm your employment record. One must be your Manager at your current/last employer. Please do not use relatives, partners or friends and employment referees. If this is your first employment, please give the name and contact details of your tutor at college/school.

Reference 1

This must be your current or most recent employer

Organisation address

Reference 2

Please provide a character reference:

Organisation address



Statement to be signed by the Applicant

Please complete the following declaration below. If this declaration is not completed your application will not be considered by KIDACTIVE.

Any of the above particulars may be subject to check. I understand that any false, inaccurate or incomplete information could result in Termination or withdrawal of any offer of employment.

I declare that the information given by me on this form is, to the best of my knowledge, correct and complete.