APPLICATION FOR EMPLOYMENT

(Please complete this form)

PART 1

(Note: Part 1 will not be used in the initial selection procedure)

Post Title:

Full time / Part time (Please circle)
Full TimePart Time

Date of Birth:

Telephone Numbers:

References: Please give names and addresses of 3 referees, one must be your present or most recent employer

References 1

References 2

References 3

(References will normally be taken up prior to interiew. If you do not wish us to contact any of your referees, please indicate clearly on this part of the form)

I certify that the information that I have given on this and the attached form is correct to the best of my knowledge and belief:

Date:

PART 2

Education and Qualifications

(Training and / or professional courses that have taken over 6 months to complete)

Short Courses

Do you own your own transport? (Please circle)
YESNO

Do you have any endorsements? (Please circle)
YESNO

CURRENT OR MOST RECENT POST

Dates from / to:

PREVIOUS EMPLOYMENT

Start Date

End date

(Please explain any gaps in your employment)

CONFIDENTIAL INFORMATION

Any information given will be completely confidential and will be considered only in relation to an application

Under the Equality Act 2010 the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at:

www.gov.uk/definition-of-disability-under-equality-act-2010.

For the purposes of this application and the interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?

YESNOPREFER NOT TO DISCUSS

Are you related to a member of staff at Time2Care? (Please circle)
YESNO

Are you eligible to work in the UK? (Please circle)
YESNO

Do you require a work permit? (Please circle)
YESNO

Please note minimum age legislation dictates that care workers in general must be 18 years old or older.

Rehabilitation of Offenders Act 1974

TIME 2 CARE (SOUTH WEST) LTD aims to promote equality of opportunity and is committed to treating all applicants fairly regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. TIME 2 CARE (SOUTH WEST) LTD undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared.Answering 'yes' to the question below will not necessarily prevent your employment. This will depend on the relevance of the information you provide in respect of the nature of the position and the particular circumstances.

Are you currently bound over or do you have any current UNSPENT convictions that have been issued by a Court or Court-Martial in the United Kingdom or in any other country?

YESNO

Do you have any current UNSPENT police cautions, reprimands, or final warnings in the United Kingdom or in any other country?

YESNO

Are there any other matters that may be relevant to your suitability to work for Time2Care (Please circle)
YESNO

If yes, please give exact details below, ensuring any information, which may be published in an Enhanced Disclosure.

LETTER OF APPLICATION (Please read the job description and person specification and, using examples, show how your knowledge, skills and experience meet each of the essential requirements of the person specifications.)

Date: