Monday, October 22, 2018
   
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  01646 621025       07867360699

 

Job Application

PRESTIGE CARE APPLICATION FORM

 

 

Position applied for___________________________________________________________

 

Available to take up employment (Date) ______________/_____________/______________

Please note that current legislation means you would not be able to start work with us until receipt of satisfactory CRB checks (currently taking 1 – 4 weeks)

Full-time:­­­­­­­­­­­­_____________             Part-time:_________________

 

Personal Details:

 

Surname:______________________________ Forenames:____________________________

 

Address:____________________________________________________________________

 

_____________________________________________________ Postcode:­­_­­­­­­­­_____________

 

Telephone No._______________________________________________________________

 

Date of Birth:___________/_______________/___________

 

National Insurance No: _____ _____ ______ _____ _____

 

Ethnic Origin: ______________________________________

 

Marital Status: Married / Single / Widowed / Divorced / Separated

 

Do you own a car?         YES / NO

 

Have you a current driving licence?           Provisional / Full / No

 

Please give details of any endorsements:___________________________________________

 

 

Are you in good health?   YES / NO

 

Are there any disabilities which may affect your application?   YES / NO

 

If YES, please describe disabilities: ______________________________________________

 

 

Are you registered disabled? YES / NO If YES, RDP Number: _______________________

 

 

Educational Qualifications: ­­­­­­­­­­­­­_____________________________________________________

 

 

Professional Qualifications:       _________________________________________________

 

 

 

By law, we are required to have a FULL employment history of all employees on our file. Please state most recent employer first. Please can you fill in the following leaving no gaps. If you were unemployed, traveling, recuperating from an illness, at home with children or other please state with dates.

 

 

Name and Address of Company/Organisation

 

 

Dates of employment   From:                                                   To:

Main duties:

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving:

 

 

 

 

Name and address of Company/Organisation

 

 

Dates of employment         From:                                               To:        

Main Duties

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving

 

 

 

 

 

 

 

 

Name and address of Company/Organisation

 

 

Dates of employment         From:                                               To:        

Main Duties

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving

 

 

 

 

 

Name and address of Company/Organisation

 

 

Dates of employment         From:                                               To:        

Main Duties

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving

 

 

 

 

 

 

Name and address of Company/Organisation

 

 

Dates of employment         From:                                               To:        

Main Duties

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving

 

 

 

 

 

Name and address of Company/Organisation

 

 

Dates of employment         From:                                               To:        

Main Duties

 

 

 

 

 

 

 

 

 

 

 

Reason for leaving

 

 

 

 

Please continue on plain paper if you require further space.

 

Interests and Hobbies …………………………………………………………………….. ………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

 

 

 

Have you ever been convicted of a criminal offence? YES/NO.   If YES, please give details.

 

 

 

If you are offered this position will you continue to work elsewhere? YES/NO. If YES, please give details.

 

 

Give the full names and addresses of two referees, one should be from your most recent employer:

 

Referee No. 1

 

 

 

 

 

 

Referee No. 2

 

 

 

 

 

 

Declaration:

I confirm that the information given is correct and understand that any misrepresentation will invalidate this application and, if employed, could lead to my dismissal. I am prepared to undergo a medical examination if required and confirm to the best of my knowledge that there are no medical reasons that would prevent me from undertaking the duties of this post.

 

 

Signed…………………………………………………….

 

Date…………………………………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please use this page to write a letter in support of your application.