THE INFORMATION YOU SUPPLY ON THIS FORM WILL BE TREATED IN CONFIDENCE.
Section 1 - Personal Details
If you are successful you will be required to provide relevant evidence of the above details prior to your
Section 2 - Present Employment
Section 3 - Previous Employment
Section 4 - Education
Section 5 - Training and Development
Practical Experience (FOR THOSE APPLYING FOR CARE / SUPPORT WORK ONLY). To assist us in finding suitable work for you, please tick all the care tasks in which you are experienced.
Please indicate your level of proficiency according to the scale below
Level of Practice & Data Achieved
Training Received Date and Certificate
Section 6 - Personal Statement
Section 7 - Rehabilitation of Offenders Act (1974)
Section 8 - Protecting Children and Vulnerable Adults
Due to the nature of our business, you are required to submit a Criminal Records Bureau check. Any
enhanced disclosures made by the DBS will remain strictly confidential.
Section 11 - References
Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do
this, please clearly outline who your references are.
Section 12 - Recruitment Monitoring Form
This sheet will be separated from your application form upon receipt and does not form part of the
selection process. It will be retained by the Human Resources purely for monitoring purposes.
To help us ensure that our Equal Opportunities Policy is fully and fairly implemented (and for no other reason)
please COMPLETE THIS SECTION OF THE APPLICATION FORM.
What is your Ethnic Group?
Choose ONE section from A to E, to indicate your cultural background.
Statement to be Signed by the Applicant
Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered.
Candidates selected for an interview will normally be notified within four weeks of the closing date.
If you return this form by email, you will be asked to sign your application at interview.
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