Registration

Important

Please ensure that you complete the application form in full as we cannot accept CVs. Please complete with black ink and block capitals. This form will be kept confidential. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural, religious, political beliefs, disability, ethnicity, gender, race, relationship status, sexual orientation, and / or Trade Union membership or stewardship.

Full Name

Date of Birth

Gender

Place of Birth

Phone

Are you a citizen of the EU?

Do you need a work permit?

Current driving license?

Do you have a car for work use?

National Insurance Number

Next of Kin Name

Next of Kin Phone number

Next of Kin Address

Position Applied For

House Number

Town/City/County

Post Code

Country

Work Preference

Full Time Part Time Hybrid

Hours Requested (HRS.)

Because of the nature of the work involved, the post for which you are applying is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Offenders Act (Exemption Order 1975).
This means that you are not entitled to withhold information relating to any convictions you may have had. Do you have any convictions to disclose? YES NO
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.
Do you have any convictions to disclose? If yes, kindly give details.
YES NO

Convictions details

Date

Upload your CV/Resume' (Must be up to Date. If there are any gaps in employment, please provide an explanation)

Upload your EVISA

Upload your DBS Certificate (Must be registered on the Update Service)

Upload your Sharecode

Upload your Passport

Upload all your care courses certificates (Certificates must be CSTF-aligned and either in date or completed within the last 12 months)

Upload your either P45 or P60 Form (Either document is acceptable)

Upload proof of National Insurance (Must be a letter from the DWP or a National Insurance card.)

Upload Proof of Address 1 (Acceptable documents include a bank statement dated within the last 3 months, a full or provisional driver's license, a utility bill—water, gas, or electric—or a council tax bill issued within the last 12 months)

Upload Proof of Address 2 (Same acceptable documents as above)

References Please supply us with two professional referees. One must be from your present or most recent employer and must be a senior grade to yourself and you must have worked for that person for a period of not less than three months duration.
Name of Referee

Position

Work Address

Post-Code

Work Email

Telephone

Name of Referee 2

Position

Work Address

Work Email

Post-Code

Telephone

The information in this application form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed. Where applicable, I consent that can seek clarification regarding professional registration details.
I declare that the answers to the above questions are true and complete to the best of my knowledge and belief.
Yes No

Type your full name to indicate signature

Date of Submission

Registration

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