Employee Online Application Form

EMPLOYEE APPLICATION FORM

Candidates are required to complete all sections of the application form. All information will be treated as strictly confidential and no approach will be made to any person without your permission.

(Please note, this application form will not be supported if your current default internet browser is Microsoft Internet Explorer, you will need to use an alernative browser)

If you need any support completing this application form please contact the Recruitment Team on 01772 321480/recruitment@venturihealthcare.co.uk
Care Home/Location Applying for:
Position Applying For:
Registration/ NMC PIN number
if 'Other' please detail the position below:
If you obtained this position, would you continue in any other employment?
Where/How did you hear about the vacancy?

Other
If you were recommended by a Venturi Healthcare employee, please provide their name below:

PERSONAL DETAILS
Your Full Name:

First NameLast Name
Other Name(s):
Address:

Street Address

Street Address Line 2

Town/CityCounty

Postcode
Telephone Number (Mobile):
Format: 00000000000.
Telephone Number (Home):
Format: 00000000000.
Contact Email:
example@example.com
Are you entitled to enter or remain in the UK and undertake the work in question?
If you have answered 'No' to this question it will mean we will be unable to proceed with your application at this time.

Please could you answer this question again to confirm.
Please confirm that you are entitled to enter or remain in the UK and undertake the work in question?
If applicable, please provide details of any visas here:

Unfortunately, as you are not entitled to enter or remain in the UK to undertake the work in question we will not be able to consider your application at this time.

If you have any questions, please email recruitment@venturihealthcare.co.uk

Thank you for your interest in joining the team at Venturi Healthcare.
Do any of your family members currently work for Venturi Healthcare?
If so, which Care Home/Location?
Do you hold a current full UK driving licence?
Does your driving licence have current penalty points or Endorsements?
Any motoring prosecutions pending?
If yes, please give details:

EDUCATION
Please list Certificates Gained at School:
Please provide details of any Further and Higher Education courses for which a certificate e.g. NVQ, SVQ, HNC, HND, degree or diploma was awarded:
Membership of Professional Bodies (Current Membership only)

Present (or most recent) Employment

If you have not been previously employed, please enter N/A in the 'Job Title' field below.
Current/Most Recent Job title:
Date Employment Started:
Are you still employed?
Date Employment Ended:
Reason for Leaving:
Employer Full Address (including Company Name):

Street Address

Street Address Line 2

Town/CityCounty

Postcode

FULL EMPLOYMENT HISTORY

Please provide YOUR FULL EMPLOYMENT HISTORY to date, starting with your most recent employer. Please note that references may be sought from any of your previous employers.
Please outline ALL GAPS IN YOUR EMPLOYMENT HISTORY since leaving school (include dates and reasons of all employment gaps of over one month):

REFERENCE DETAILS

Please provide the details of two people who have consented to act as referees on your behalf, one of whom should be your most recent employer. References must cover at least the last 3 years. If you have not been employed previously, you will need to provide details of two professional character references covering at least the last three years. Referees cannot be a family member or a friend, they must have known you in a professional capacity e.g. Teacher, Tutor, Manager, Supervisor, Colleague, Group Leader

PLEASE NOTE, YOUR CURRENT EMPLOYER WILL NOT BE CONTACTED FOR A REFERENCE UNTIL AN OFFER OF EMPLOYMENT HAS BEEN MADE AND ACCEPTED
Reference 1

Dates of Employment/Period Covered:
From:
To:
Type of Reference:
Referee Name:
Referee Job Title:
Company Name:
Contact Address:

Street Address

Street Address Line 2

Town/CityCounty

Postcode
Contact Email:
example@example.com
Contact Phone Number:
Please enter a valid phone number.Format: 00000000000.
Reference 2

Dates of Employment/Period Covered:
From:
To:
Type of Reference:
Referee Name:
Referee Job Title:
Company Name:
Contact Address:

Street Address

Street Address Line 2

Town/CityCounty

Postcode
Contact Email:
example@example.com
Contact Phone Number:
Please enter a valid phone number.Format: 00000000000.
Additional Referee Contact Details should the above not cover 3 years (please indicate type of reference and relationship to the person providing the reference)

Venturi Healthcare

Employee - Consent to Obtain References
Declaration

At Venturi Healthcare it is Company Policy to ensure satisfactory references are received to proceed with employment.

By completing this form, you give us full permission to approach current/previous employers to obtain references.
Name:

First NameLast Name
Signature:
Date:

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate

PRIVACY NOTICE - IMPORTANT

(Please read carefully before signing)

Data Protection

We process personal data relating to those who apply for job vacancies with us or who send speculative job applications to us. We do this for employment purposes, to assist us in the selection of candidates for employment, and to assist in the running of the business. The personal data may include identifiers such as name, date of birth, personal characteristics such as gender, qualifications and previous employment history.

We will not share any identifiable information about you with third parties without your consent unless the law allows or requires us to do so. The personal data provided during an application process will be retained for a period of at least six months or, if required by law, for as long as is required.

This privacy notice does not form part of an employment offer or contract between us. If we make an employment offer to you, we will provide further information about our handling of your personal information in an employment context separately.

If you would like to find out more about our data retention policy and how we use your personal data, you want to see a copy of the information about you that we hold or have any questions or issues regarding data protection, please email us with the Subject “Data Protection Request”.
Do you give consent for your personal data to be processed in accordance with this policy?
If you have answered 'No' to this question it will mean we will be unable to proceed with your application at this time.

Please could you answer this question again to confirm.
Please confirm that you give consent for your personal data to be processed in accordance with this policy?

Unfortunately, as you have not given your consent for us to process your personal data in line with our outlined policy; we will not be able to process your application at this time.

If you have any questions, please email recruitment@venturihealthcare.co.uk

Thank you for your interest in joining the team at Venturi Healthcare.
Do you have any physical or mental health conditions which are relevant to your capability, after reasonable adjustments are made, to properly perform the tasks which are intrinsic to this employment?
If yes, please provide details:

Declaration Under the Protection of Freedoms Act 2012

The post for which you are applying is a ‘regulated activity’ within the meaning of Part 5 Chapter 1 of the Protection of Freedoms Act 2012 and it is a criminal offence for a ‘barred person’ to apply to work in a regulated activity. If you are a barred person you must not proceed with this job application.

If your application is successful you will be required to co-operate with us in obtaining a disclosure of criminal convictions and in checking your barred status with the Disclosure and Barring Service.
Are you a barred person?
Do you have any outstanding safeguarding investigations or suspensions, criminal prosecutions or convictions that might lead to your being barred from working on child-orientated premises (e.g. schools), with children or with protected adults?
If "Yes", please give full details:
Do you have any convictions, cautions, reprimands or final warnings that would not be filtered in line with current guidance?
If "Yes", please give full details:
Full Name:

First NameLast Name
If you have previously had any other surname(s) or forename(s), you must declare all of them below and state the date of each change and the reason.
Declaration

The above information is true. I understand that any job offer made on the basis of untrue or misleading information may be withdrawn or my employment terminated. I understand that I will have to provide evidence of my covid vaccination status at point of interview.
Signed:
Date:

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Statement on the recruitment of ex-offenders

Introduction

As an organisation using the Disclosure and Barring Service’s (DBS) checking service to assess applicants’ suitability for positions of trust, we comply fully with the Code of Practice and undertake to treat all applicants for positions fairly. We undertake not to discriminate unfairly against any subject of a DBS check on the basis of a conviction or other information revealed.
We are committed to the fair treatment of our employees, potential employees and users of our services, regardless of their offending background.

Policy

We actively promote equality of opportunity for all with the right mix of talent, skills and potential and welcome applications from a wide range of candidates, including those with criminal records. We select all candidates for interview based on their skills, qualifications and experience.
A DBS check is only requested after a thorough risk assessment has indicated that one is both proportionate and relevant to the position concerned. For those positions where a DBS check is required, all application forms, job adverts and recruitment briefs will contain a statement that a DBS check will be requested in the event of the individual being offered the position.
Where a DBS check is to form part of the recruitment process, we encourage all applicants called for interview to provide details of their criminal record at an early stage in the application process. We request that this information is sent under separate, confidential cover, to a designated person within the organisation and we guarantee that this information will only be seen by those who need to see it as part of the recruitment process.
Unless the nature of the position allows us to ask questions about your entire criminal record, we only ask about ‘unspent’ convictions as defined in the Rehabilitation of Offenders Act 1974.
We ensure that all those who are involved in the recruitment process have been suitably trained to identify and assess the relevance and circumstances of offences. We also ensure that they have received appropriate guidance and training in the relevant legislation relating to the employment of ex-offenders, e.g. the Rehabilitation of Offenders Act 1974, and in the secure handling of “sensitive personal data”, e.g. DBS checks.
At interview, or in a separate discussion, we ensure that an open and measured discussion takes place on the subject of any offences or other matter that might be relevant to the position. Failure to reveal information that is directly relevant to the position sought could lead to withdrawal of an offer of employment.
This policy document is made available to all DBS applicants at the outset of the recruitment process and we make every subject of a DBS check aware of the existence of the Code of Practice and make a copy available on request.
We undertake to discuss any matter revealed in a DBS check with the person seeking the position before withdrawing a conditional offer of employment.
Should be Empty:

EMPLOYEE APPLICATION FORM

Candidates are required to complete all sections of the application form. All information will be treated as strictly confidential and no approach will be made to any person without your permission.

(Please note, this application form will not be supported if your current default internet browser is Microsoft Internet Explorer, you will need to use an alernative browser)

PERSONAL DETAILS

EDUCATION

Present (or most recent) Employment

FULL EMPLOYMENT HISTORY

REFERENCE DETAILS

Reference 1

Reference 2

PRIVACY NOTICE - IMPORTANT

(Please read carefully before signing)

Statement on the recruitment of ex-offenders