Apply for Job – Caredo-ltd

Apply Job

Position applied for

Date of application

PERSONAL DETAILS

Surname

First name

Previous Name

Address

Home Telephone No.

Mobile No.

Email Address

National Insurance Number

Current driving licence

Do you have a car for work use?

Yes

Immigration Details

Are you a citizen of the EU?

Yes

Do you need a work permit?

Yes

EDUCATION

Education Detail

Schools/FE/HE attended	Examination Grade	Year Obtained

PREVIOUS EMPLOYMENT

A full employment history must be detailed beginning with your current employment and covering all reasons for gaps in any given year.

Previous Employment

Date From	Date To	Employer’s name	Position held	Salary & Benefits	Reason for leaving

Please detail any disciplinary action within the previous 3 years, including any current, “live” formal warnings

REHABILITATION OF OFFENDERS ACT 1974 – NOTICE TO OFFENDERS

Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)

The amendments to the Exceptions Order 1975 (2013) provide that certain convictions and cautions are protected and are not subject to disclosure to employers and cannot be taken into account

Do you have any convictions to disclose?

Yes

Do you have any convictions to disclose? if yes ?

Any information should be given on a separate sheet and sent with this application form. This information will be treated as confidential and will not necessarily preclude you from employment.

Failure to declare or the falsification of any of the above details will result in the withdrawal of any job offer.

Signature or Your Name

Date

ADDITIONAL PERSONAL DETAILS

Statement of your personal qualities and any experiences which is relevant to the post

REFERENCES

Please give the name and address of two referees, one of whom must be your current or most recent previous employer. References from relatives or friends are not accepted.

REFERENCES

Name	Status	Address and Telephone No

This organisation seeks to work in a flexible and family-friendly manner with its staff, however, unsocial hours are part and parcel of a quality care service. Weekend working is a requirement for all staff, the frequency of which will be determined at the interview.

Please indicate holiday dates if already booked

Period of notice required in the present post

Earliest start date

I declare that to the best of my knowledge, all the information contained and documented herein is complete and truthful.

Signature or Your Name

Date

FOR OFFICE USE ONLY

Interview Date

References Requested

Yes

Verbal Reference Check

Yes

Additional Notes from the Application

Completed by

Date

Notes for Interview

Equal Opportunities Monitoring

This section of the application will be detached and used for monitoring purposes only. Our organisation recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect in line with the Equality Act 2010 legislation. We welcome applications from all sections of the community.

Date Of Birth

Gender

Race Relations (Amendment) 2000

I would describe my ethnic origin as (please indicate with an X):

Asian or Asian British

Mixed Raced

Other Ethnic Group

Black or Black British

White

Please select the option which best describes your sexuality

Please indicate your religion or belief

Health Questionnaire

(To be used for those applicants that have been deemed appointable)

To comply with the Equality Act 2010, please complete this questionnaire as fully as possible. Failure to do so could impede or delay your appointment. All information is confidential.

Are you registered disabled? (If yes, please detail below)

Please List Below any Periods spent Outside of the United Kingdom as a Resident (do not include holidays)

Please List below any vaccinations or immunisations

Date	Immunisation	Expiry

GP Surgery

Name of GP Surgery

GP Full Name

NHS Number

Address including Postcode

Telephone number

Email Address

Emergency Contact

Title

Name in Full

Relationship

Address including Postcode

Telephone number

Next of Kin Details

Title

Name in Full

Relationship

Address including Postcode

Telephone number

I declare that the information given is correct to the best of my knowledge. In my view, I am fit physically and mentally to undertake this post. I understand that omissions or false statements may disqualify me from employment or lead to dismissal. I give the employer the right to investigate all references.

Signature or Your Name

Date

PERSONAL DETAILS

Immigration Details

EDUCATION

PREVIOUS EMPLOYMENT

REHABILITATION OF OFFENDERS ACT 1974 – NOTICE TO OFFENDERS

Failure to declare or the falsification of any of the above details will result in the withdrawal of any job offer.

ADDITIONAL PERSONAL DETAILS

REFERENCES

FOR OFFICE USE ONLY

Equal Opportunities Monitoring

Race Relations (Amendment) 2000

Health Questionnaire

GP Surgery

Emergency Contact

Next of Kin Details

Our Services