SECTION 1
Forenames
Address (required)
Phone (required)
Mobile
Email (required)
National Insurance Number (required)
How Did You Hear About us? (required)
If Yes, What Documents Will you Provide To Prove This?
SECTION 2
What Is The Earliest Date You Can Start With Us?
When Are You Available To Work?
SECTION 3
Please Tell Us About The Languages you Can Speak And/Or Write?
Other Languages
Please Tell Us About Any Formal Qualifications You Have Achieved?
Please Tell Us About Any Formal Qualifications You Have Achieved?
SECTION 4
We are required by law to make sure we know about the work you have done in the past, as well as the periods you may have spent out of employment. Therefore, please list your full employment history here, including any periods when you were not working (along with an explanation of what you were doing). Please use extra sheets if you need more space.
Please provide information as - Dates - Employer - Location - Job Role - Reason For Leaving
SECTION 5
Please provide the details of at least three people that we can write to for a reference. The first must be your most recent employer.
If you do not have the details of three previous employers, you may substitute one or more of these with a referee who was your tutor or teacher when you were in formal education.
If you do not have the details of a teacher or tutor, we may accept a personal reference from a person of professional standing (e.g a doctor, lawyer, accountant) who knows you, either professionally or personally.
You must not give the names of friends or family members. All references will be verified.
First Referee
Name - Position - Organisation - Address - Phone - Email - Dates Of Employment
Second Referee
Name - Position - Organisation - Address - Phone - Email - Dates Of Employment
Third Referee
Name - Position - Organisation - Address - Phone - Email - Dates Of Employment
SECTION 6
Name
Address
Phone
Mobile
Relationship
SECTION 7
Care workers work with vulnerable people and we take our responsibility to protect them very seriously. Your appointment will depend on the satisfactory completion of a criminal record disclosure (see our policy statement below), but at this stage, we need you to answer the following questions with truth and honesty.
If you answered ‘yes’ to either of the two previous questions, please provide details:
Note that: if once a criminal records disclosure has been completed and it is discovered that you have failed to accurately disclose information requested above, the company reserves the right to terminate your employment without notice. Please be aware about our policy on the recruitment of ex-offenders, if you have any questions regarding this, please contact the office where a member of The Leading Care Company will be happy to help you.
Criminal records disclosures – The Leading Care Company Policy
As an organisation assessing applicants’ suitability for positions which are included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order using criminal record checks processed through the Disclosure and Barring Service (DBS), The Leading Care Company complies fully with the Code of Practice and undertake to treat all applicants for positions fairly. We will not discriminate unfairly against any subject of a criminal record check based on a conviction or other information revealed.
The Leading Care Company can only ask an individual to provide details of convictions and cautions that we are legally entitled to know about. Where a DBS certificate at either standard or enhanced level can legally be requested (where the position is one that is included in the Rehabilitation of Offenders Act 1974 (Exception) Order 1975 as amended) and where appropriate police Act Regulations (as amended), The Leading Care Company can only ask an individual about convictions and cautions that are not protected.
SECTION 8
If you have answered ‘yes’ to the above, please give brief details
SECTION 9
Please read the following statements carefully. If there is anything you do not understand, please contact our office before signing the bottom of the page.
I, the job applicant named on the front of this form, confirm that the information I have given in this application is accurate and true to the best of my knowledge. I also understand and agree that:
The Leading Care Company may make checks to verify the information I have provided;
Providing misleading or false information in this form or at any time during the application process may disqualify me from appointment or, if I have already been appointed, may result in my dismissal.
The personal information I have provided in this form (and any other personal information that I or my referees may provide) is confidential and will be handled in line with the Data Protection Act 1998;
The Leading Care Company will use the personal information I have provided to decide if I am suitable for the position I have applied for;
Until I am employed, The Leading Care Company will not use my personal information for any purpose other that monitoring its own recruitment processes.
If my application is successful, my personal information will be used for legitimate purposes in relation to my work (my contract of employment, which I will sign before I start work, will include further details on how my information may be used);
The Leading Care Company may process my personal information for the purposes described above or as otherwise permitted or required by law in line with its registration with the information commissioner;
Any offer of employment will depend on the receipt of satisfactory employment references and the satisfactory completion of a criminal records disclosure (refer to section 7);
I will be required to complete a pre-employment induction training program prior to my starting work with The Leading Care Company;
Date Of Declaration
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