01484 536865
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Role

Full Time/Part Time
Please check all you can work.

Desired Work Times
Please check all you can work.

care home huddersfield

Personal Details

If you have resided at this address for less than 5 years, please provide details of your previous address below.

Note: Minimum age legislation dictates that Care workers in general must be 16 years old or older. Please inform your interviewer immediately if you do not meet these specifications.

Do you have a reliable/dependable vehicle to use for work?


Clean driving license?


Education

Please give information about qualifications gained relating to the role you are applying for. Include your grade and where you recieved the qualification from. Please note if your application moves on to the inverview` you may be asked to provide proof of these.

Training History/Professional Status

Please give information about any additional training undertaken relating to the role you are applying for. Include what the training was, the date you received it, and where you recieved it. Please note if your application moves on to the interview stage you may be asked to provide proof of these.

care home huddersfield

Previous Employment

Present/Most Recent Employer

Previous Employer

care home huddersfield

Assistance With Interview

Do you require us to make any special arrangements in order for you to participate in the recruitment process? For example, large print forms? Or additional time to complete forms?

Additional Information

Note: Minimum age legislation dictates that Care workers in general must be 16 years old or older. Please inform your interviewer immediately if you do not meet these specifications.

Do you need a work permit to work in the UK?

care home huddersfield

Referees

You must provide references from your two most recent employers. Please provide an additional character referee, if only one employer can be contacted. All will be contacted; therefore, please inform the referees of the fact you have used their name. If you are unable to provide the required references, please discuss the matter with us.

Reference 1

Can we contact this person at any time?

Reference 2

Can we contact this person at any time?

Character Reference

Can we contact this person at any time?

Criminal Conviction Declaration

Workers of The Agency are subject to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and will be subject to a Police Record Check through the DBS. Please declare all criminal convictions, whether spent or not, charges, whether proceeded with or not, and warnings and cautions.

Please note, you may not be eligible for work in a Care setting if you are on the DBS Register(s).

Please declare all criminal convictions, whether spent or not, charges, whether proceeded with or not, and warnings and cautions.

Declaration

I declare that to the best of my knowledge and belief the information given by me in this application is true, and I understand that the above information forms the basis of my contract of employment. I understand that if any of the information supplied by me is found to be falsely declared, my contract may have been fundamentally breached and my employment may be terminated immediately.

I understand that I may not be offered a post until a satisfactory response has been received with respect to my DBS Register status, and that should I subsequently be offered a post, that offer will be subject to receipt of two satisfactory references, one of which must be from my previous employer, and that confirmation of the employment will be subject to a satisfactory criminal record check from the DBS.

I understand that until a satisfactory response is received from the DBS, and my employment is confirmed, I will be supervised at all times at work and will not seek or have unsupervised access to vulnerable people. If the post I have applied for is as a Registered Nurse, my confirmation of employment will also be subject to a satisfactory search of the Nursing and Midwifery Council records and registers. By my signature, I authorise Able Care Huddersfield LTD to request a DBS Register check and a criminal record check from the DBS, on initial employment and at any time during my employment thereafter. I undertake to inform my employer immediately if my DBS Register status or criminal status changes at any time during my employment, such as by being charged with an offence (other than motoring offences), the administering of a warning, criminal conviction, referral to any register of barred Care workers, or withdrawal of any registration required by my employment status.