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Job application form

Step 1 of 6 - Personal details

16%
Name(Required)
Address(Required)
Academic education & training(Required)
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College/Training provider
Qualification/Subject
 
Vocational education & training(Required)
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College/Training provider
Qualification/Subject
 

Current / Most recent employer

Previous Employers
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Employer
Dates in the role
Job title
Reason for leaving
 

Reference 1

Please supply the names of two referees whom we are able to approach prior to the appointment. One must be your most recent employer.
May we contact prior to interview?(Required)

Reference 2

Please supply the names of two referees whom we are able to approach prior to the appointment. One must be your most recent employer.
May we contact prior to interview?(Required)
Please explain how you meet the requirements identified in the Job Description / Job Specification, detailing any skills, aptitudes, knowledge, and experience you possess that you feel are appropriate to the role you are applying for:
Workers of The Home are subject to the Health and Social Care Act 2008, 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).
Are there any restrictions to your residence in the UK which might affect your right to take up employment in the UK?(Required)
If you are successful in the application, would you require a work permit prior to taking up employment?(Required)
If offered this position do you intend to continue working in any other capacity?(Required)
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 Baxendale Care Home to request a DBS Register check and a criminal records 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.
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Date(Required)
This field is for validation purposes and should be left unchanged.
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