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Complete the application form and submit

Post Apply for(Required)

Date available to start(Required)

Upload ID photo(Required)

Max. file size: 128 MB.

Personal Information

Name(Required)

Prefix First Last

Email(Required)

Phone(Required)

Date of birth(Required)

National Insurance No:(Required)

NMC Pin No: (Nurses Only)

Address(Required)

Street Address Town/City Postal Code

Personal Details

Nationality(Required)

Gender(Required)

Religion(Required)

Race/Ethnicity(Required)

Sexual Orientation(Required)

Employment Eligibility

Are you permitted to work in the United Kingdom?(Required)

Yes

Yes No Can you provide evidence to prove eligibility(Required)

Yes

What visa/permit/status do you currently hold?(Required)

Working Holiday

Work Permit

Leave to Remain

I don't need a Visa

Other

Please state what visa/permit you hold (If applicable):

Permit/Document No (If applicable):

Visa/Permit Expiry Date (If applicable):

Driving Details

Do you have full Driving License that allows you to drive in the UK?(Required)

Yes

If yes, please enter your Driving License No:

Languages

English – Spoken(Required)

Fluent

Good

Fair

English – Written(Required)

Fluent

Good

Fair

Other Languages Spoken:

Next of kin details

Name(Required)

First Last

Relationship

NOK Phone Number

NOK Address(Required)

Street Address Town/ City Postal Code

Work History

We need up to 10yrs work history please with no gaps.

Previous Job Title / Position Held(Required)

Date Previous Job Started(Required)

Date Previous Job Ended(Required)

Previous Job Title / Position Held

Previous Job Description (Please list all other work history below, including start and end dates)

Education/Qualification History

Institution(Required)

Course(Required)

Year(Required)

Grade(Required)

Education (Please list all other education history below, including Courses, Years and Grades)

Upload CV if you have one.(Required)

Drop files here or

Max. file size: 128 MB.

References

Ref Name 1(Required)

Relationship(Required)

Ref 1 Email

Ref 1 Phone Number(Required)

Ref 1 Address

Street Address City/Town ZIP / Postal Code

Ref Name 2(Required)

Relationship(Required)

Ref 2 Email

Ref 2 Phone Number(Required)

Ref 2 Address

Street Address City/Town ZIP / Postal Code

Skills Experience & Training

Please click on which training you have completed and the date on the notes (certificates must be provided).

Manual Handling

Basic life support

Health and Safety

Infection Control

Other

Health Declaration

Do you or have ever suffered from long term illness?(Required)

Yes

Have you ever required sick leave for a back or neck injury?(Required)

Yes

Do you suffer with any back or neck injuries?(Required)

Yes

Have you been in contact with anyone who is suffering from a contagious illness within the last six weeks?(Required)

Yes

Do you suffer with a communicable disease?(Required)

Yes

If you have answered ‘yes’ to any of the above, please give details:

Are you currently receiving active medical attention?:(Required)

Yes

Are you registered disabled?(Required)

Yes

How many days have you been absent from work due to illness in the last 12 months?

State reason(s) for absence:

GP Name:(Required)

GP Surgery Name:(Required)

GP Address:(Required)

Street Address Address Line 2 Town/City GP Postal Code

GP’s Phone Number:(Required)

May we contact your Doctor for health check?

Yes

Please Note The above information will be held in strict confidence. If you are aware of any health issue that you feel may affect your ability to undertake responsibilities of the post, it is your responsibility to inform the Care Manager immediately. Again any details discussed in the meeting will be held in strict confidence.

DBS Declaration

Do you have a current DBS (Disclosure Barring Service) certificate?:(Required)

Yes

Please enter disclosure number

Date of issue

Reference Number (if applicable):

DBS Check(Required)

I agree to the privacy policy.

I understand that a DBS check will be sort in the event of a successful application.

Terms of employment

If any provision of this Agreement should be held to be invalid it shall to that extent be severed and the remaining provisions shall continue to have full force and effect. You may be required to use personal vehicle to and from work. No fuel reimbursement will be given. You are responsible for meeting the cost of DBS Disclosure. The employer, in some circumstances, may agree to advance the cost only if you agree it to be deducted from your pay. Carers will achieve NVQ Level 2 within 2 years of the start of employment. All care staff and trainees, including all staff under 18, will register on and successfully complete Skills for care certified training programme. The Company has written and published a formal policy/procedure document covering employee grievances which relate to your employment. The document is entitled “Employee Discipline” and is available for review at any reasonable time. Please contact your Manager for further information, or to request to review a copy. If you are dissatisfied with any disciplinary or dismissal decision relating to you then you should, in the first instance, apply in writing, to the Care Manager stating the grounds for your appeal. The person who will consider the appeal may vary according to individual circumstances. The Company has written and published a formal policy/procedure document covering employee grievances which relate to your employment. The document is entitled “Employee Grievances” and is available for review at any reasonable time. Please contact your Care Manager for further information, or to request to review a copy. If a grievance cannot be resolved informally then you must put your grievance, in writing to your Care Manager. A simple form has been designed for this purpose. Employees with reading or language difficulties should seek assistance, for example, from a work colleague. Subsequent steps, including the right of appeal, are explained in the formal document. The following documents form part of this statement: Employee handbook Policy and procedure manual Notices

Terms of employment(Required)

I have read and agree to the terms.

Online Application