Name * First Last Date of Birth * Email Address * Position Applied For * Address * House number/Street City * Post Code * NI Number * National Insurance Number Employment History Please complete your last five years employment activities starting with the most recent moving your way down. Name of employer: 1 * Date started * Date ended * Brief description of role and responsibilities * Reason employment end * Employer 2 Name of employer: * Date from * Date ended * Brief description of role and responsibilities * Reason employment end * Employer 3 Some description about this section Name of employer: Date from Date ended Brief description of role and responsibilities Reason employment end Employer 4: Name of employer: Date from Date ended Brief description of role and responsibilities Reason employment end Declaration Are you currently under investigation from current employment, ever been dismissed or suspended from any employment? Yes or No * If YES to above, please Explain Education History 1 Please start your recent education history starting with the most recent. Place of Study * Date / From * Date / To * Subject * qualifications * Education History 2 Please start your recent education history starting with the most recent. Place of Study Date / From Date / To Subject qualifications Education History 3 Place of Study Date / From Date / From Subject qualifications CAUTIONS AND CONVICTIONS TextJoin Hands Care ltd reserve the right to ensure that all its employees are DBS check and cleared due to the nature of the jobs we do. Do you have any convictions spent and or unspent that will show up on your up on your DBS? Y/N * If Yes, please give details below. If NO input n/a * DECLARATIONS: Cautions, reprimands or final warnings and or convictions spent or unspent under the terms of Rehabilitation of Offenders Act 1974 must be declared prior to picking up certain employment responsibilities. I hereby declare that I do not have or know of any convictions that will hinder my job application Select * — Select — Yes No Sign * Date / Time * REFERENCES Please provide two employment history covering the last 3 years Reference 1 Name employer * Name of Refree * Email Address * Contact number * Can this referee be contacted as we process your application? * — Select — Yes No Reference 2 Name employer * Name of Refree * Email Address * Contact number * Can this referee be contacted as we process your application? * — Select — Yes No TRAINING AND CERTIFICATIONS Please list all the training and certifications you have in this section and date obtain Training and Certs ASYLUM AND IMMIGRATION ACT The Asylum and Immigration Act, it is a criminal offence for an employer to employ staff whose immigration status prevents them from working in this country. Do you have the right to work in the UK? select * YES NO Do you drive? * YES NO Willing to work nights and weekends? * YES NO when are you available to start work EQUAL OPPOTURNITY Join Hands Care Ltd treat everyone with equal and will not tolerate any form of discrimination in regards to sexuality, race, colour, religion, ethnic origin, marital status and or disability Sexuality * Male Female Any disability that we need to know of? * Yes No If YES please explain Sexual Orientation * — Select — Bisexual Heterosexual/Straight Gay Transgender Prefer not to say Ethnicity — Select — White Black Asian other DECLARETION: I declare that to the best of my knowledge all information on this form is correct and will immediately cause my employment to be terminated if they are any misinformation. sign * Date / Time * Close Menu
