Join Us Submit your job application by filling the form below Care Worker ApplicationPart One: Your Personal DetailsTitle:Sex:MaleFemaleFirst Name *Last NameAddress: *Post Code:Phone: *Select type: *MobileLandlineOtherOther Phone:Select type:MobileLandlineOtherEmail: *NI Number: *How did you hear about this job?Please select:Googlerecruit-zone.comLeafletRefer a FriendPlease select:Other search engineindeed.co.ukNewspaper AdvertWord of mouthPlease select:Company websiteOther websiteJobcentreOther (Specify)If you were told about this job by someone that works for us, please tell us their name:Do any other of your close friends or relatives already work for us?YesNoPlease give their names here:Can you prove that you are legally entitled to work in the UK?YesNoWhat document/s will you provide to prove this?Have you worked recently in a care support role?YesNoWhat was your standard hourly rate of pay?GBPPart Two: Your AvailabilityIt is really important to us that we know when you are available for work so please do your best to ensure that the information you provide in this section is correct.What is the earliest date you could start work with us?Do you have any holidays etc. already booked?YesNoPlease give dates belowPlease tick here to indicate when you would usually be available for work:MondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease choose shiftMorningLunchtimeTeatimeEveningIs there anything else we should know about your availability?Part Three: Your Skills and QualificationsPlease tell us about the languages you can speak and/or write:Language 1:Language 2:Language 3:Language 4:Do you speak or write this language? (Select the one that apply)I can speak this languageI can write in this languageMy skill level is:BasicCompetentAdvancedDo you have an NVQ/QCF level 2 (or above) in Health & Social Care?YesNoHave you completed the Care Certificate (England only)?YesNoIf you answered ‘yes’ to either of the above, you must provide a certificate or other evidence of completion.Please tell us about any other relevant formal qualifications you have achieved (including any Maths or English qualifications):When did you leave full-time education?Part Four: Your Work HistoryWe 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). You may use extra sheets if you need more space. Please start with your current or most recent employment and work backwards.Work History:Part Five: Your RefereesPlease provide the details of four people that we can write to for a reference. The first of these people must be your current or most recent employer. The other referees will ideally also be your most recent previous employers.If you cannot provide the details of four previous employers, you may substitute one or more of these with a referee who was a former tutor or teacher when you were in formal education.If you cannot provide details of a teacher or tutor, we may accept a personal reference from a person of professional standing (e.g. a doctor, lawyer, accountant, recognized religious leader, or teacher) who knows you, either professionally or personally.You must not give the names of friends or relatives or colleagues that are/were not senior to you as referees. All references will be verified.First Referee (should be current or most recent employer)Referee’s name:Position:Name of organisation, school or college:Address and post code:Phone:Email:Dates of employment or study:FromDates of employment or study:ToSecond Referee (should be current or most recent employer)Referee’s name:Position:Name of organisation, school or college:Address and post code:Phone:Email:Dates of employment or study:FromDates of employment or study:ToThird Referee (should be current or most recent employer)Referee’s name:Position:Name of organisation, school or college:Address and post code:Phone:Email Address:Dates of employment or study:FromDates of employment or study:ToPart Six: Criminal RecordCare 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 records disclosure (see policystatement below), but at this stage, we need you to answer the following questions truthfully and honestly:Have you received 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 by SI 210 1198)?YesNoPlease provide detailsTo your knowledge, are you currently the subject of any criminal proceedings (for example, charged or summoned but not yet dealt with) or any police investigation?YesNoPlease provide detailsDo you consent to our applying for an enhanced criminal records disclosure on you and to our retaining a copy of your disclosure certificate during the period of your employment or until a new disclosure is completed (whichever occurs first)?YesNote that if once a criminal records disclosure has been completed, it is discovered that you have failed to accurately disclose the information requested above, the company reserves the right to terminate your employment without notice. Please be aware, however, that your having a criminal record will not necessarily mean we cannot employ you – if you would like to know more about our policy on the recruitment of ex-offenders, please ask.Criminal records disclosures – Our PolicyAs 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), we comply 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 on the basis of a conviction or other information revealed.We 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 (Exceptions) Order 1975 as amended) and where appropriate Police Act Regulations (as amended), we can only ask an individual about convictions and cautions that are not protected.Part Seven: Suitability for the JobPlease read the care worker job description and answer the following questions.Have you read and understood the care worker job description?YesThe position for which you are applying requires physical effort (including sitting, standing, carrying, walking, moving and handling people), mental effort (including dealing with emergencies and short-notice changes to work in a fast-paced environment) and possible emotional/psychological effort (including dealing with bereavement and challenging behaviour in a potentially stressful environment).Do you have any health conditions that would prevent you from meeting these intrinsic requirements for which the company might need to make reasonable adjustments? (If yes, please be aware that we may need to discuss these with you at your interview)YesNoPlease provide brief details:Part Eight: DeclarationsPlease read the following statements carefully. If there is anything you do not understand, please ask before you sign at 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 company may make checks to verify the information I have provided; Providing misleading or false information in this form or at any other 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 company will use the personal information I have provided to decide if I am suitable for the job I have applied for; Until I am employed, the company will not use my personal information for any purpose other than monitoring its own recruitment processes and that if the company does use my personal information for statistical analysis, it will be anonymised; If my application is unsuccessful, the company will keep only basic information about me and destroy the rest; 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 detail on how my information may be used); The 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 (see part six above); I will be liable for the cost of my initial criminal records disclosure but that the company will bear the cost of any future disclosures that need to be made; I will be required to complete a pre-employment induction training programme prior to my starting work with the company; My attendance on the induction training programme will not indicate any offer (on the part of the company) or acceptance (on my part) of employment and that the time I spend on the induction programme will therefore not count as working time for the purposes of calculating the company’s compliance with National Minimum Wage regulations. Signature:Date:What happens now? If you received this form by post, return to us along with your completed Equalities Monitoring Form. We will be in touch with you to tell you whether you will be invited to an interview. If you downloaded the form from the internet, post it to the branch from which you would like to work (you will find the address on our website), making sure that you also download and complete the Equalities Monitoring Form. We will be in touch to tell you whether you will be invited to an interview. If you completed the form at one of our offices, hand it to the person that gave it to you, along with your completed Equalities Monitoring Form. It will be explained to you what will happen next. Upload CV/Resume *Choose FileNo file chosenDelete uploaded fileSubmit ApplicationSave as DraftPlease do not fill in this field.
