CANDIDATE APPLICATION FORM

  • Gevic Care Agency Ltd.

    61 Callander Road, Catford, London SE6 2QB | 07474058385 | 02082444899 | 07405174052 admin@geviccareagencyltd.co.uk | www.geviccareagencyltd.co.uk

  • CANDIDATE APPLICATION FORM

  • Next of Kin

    (In Case of emergency) IMPORTANT INFORMATION - PLEASE COMPLETE

  • Employment History

    (Most recent first)
  •  - -
  •  - -
  •  - -
  •  - -
  •  - -
  •  - -

  • Reference Authorisation

    I hereby authorize Gevic Care Agency Ltd. To seek references from my current and/or previous employer(s) or other person in relation to my personal background, educational attainments, unemployment or job seekers and/or employment history
  •  / /

  • Your Bank Details

  • EMPLOYEE STATEMENT (Read all the following statements carefully and tick the one box that applies to you)

  • Consent Declaration

    Company Name: GEVIC CARE AGENCY LTD. (The Company) Topic: General data Protection Regulatio

  • I, hereby give my consent to the Company to process the following information:

    Personal data

    •      Name

    •      Date of birth

    •      Contact details, including telephone number, email address, and postal address

    •      Experience, training and qualifications

    •      Employment history including references

    •      National insurance number

    •      Next of Kin details

    •      Identification documentation including right to work in UK

    •      Bank/payment details.

    Sensitive personal data

    •      Disability/health condition relevant to the role

    •      Criminal conviction

    •      Nationality

    •      Trade union member

    I consent to the Company processing the above personal data for the following purposes:

    •      For the Company to process my data for legitimate business reasons.

    •      For the Company to provide me with work-finding services.

    •      For the Company to process or transfer my personal data to their client/s [NHS, Private Hospitals, Private Clinical Establishments] in order to provide me with work-finding services.

    •      For the Company to ensure duty of care for their subcontractors in an emergency situation.

    •      For the Company to process my data on a computerised database [UKCRBs/GBG Disclosures, DBS Update Service, Professional Registration Checks and Online Portals for the Purpose of Supply Engagement] in order to provide me with work-finding services.

    •      For the Company to ensure fitness to work status by forwarding my personal data to their occupational health providers Healthier Business and Arumas.

    •      For the Company to send my training certificate and personal data to training providers for verification purposes.

    •      For the Company to disclose information to their client/s [NHS, Private Hospitals, Private Clinical Establishments] regarding my DBS to promote the security and protection of me, the patients, co-workers and the general public.

    •      For the Company to process my payment by forwarding my information to registered umbrella companies under their preferred supply list.

    I also consent to the Company processing my personal data with third parties including [The REC, National Frameworks, NHS, Private Hospitals and Private Clinical Establishments) for the purposes of internal audits and investigations carried out on the Company to ensure that the Company is complying with all relevant laws and obligations.

    The consent I give to the Company will last for 5 years.

    I am aware that I have the right to withdraw my consent at  any  time  by informing  the Company  in  writing  by email to admin@geviccareagencyltd.co.uk

    Please note that if there are any changes in the current legislation, we will inform you as and when they occur.

  •  - -

  • Declarations

    Opt –Out 48 hour Working Week Agreement

  • For the purpose of the Working Time Regulations 1998, I consent to work in excess of an average of 48 hours perweek. I understand that I may withdraw this consent by giving Gevic Care Agency Ltd. Not less than one months'notice. I understand that my registration with Gevic Care Agency Ltd. can be terminated at any time followingunsatisfactory work reports.

  •  - -

  • Criminal Record and Security

    As you may be working in an environment where you may come into contact with children or vulnerable adults or your assignmentmay fall within certain expected categories where this is likely to apply, you are legally required to disclose any criminal record underthe rehabilitation of offenders act 1974 (exception s) order 1975. This involves any convictions whether or not they are spent withinthe act (including any cautions, reprimands, final warnings, bind-overs or any convictions from overseas).Have you ever been convicted of a criminal offence?
  •  - -

  • Bank Details

    I have completed my bank details and confirm they are complete and correct.  I hereby understand that any incorrect orincomplete details can result in a delay of my payment.
  •  - -

  • Compliance Updates

    Many of your compliance items need to be reviewed annually.  It is your responsibility to ensure that your file is in date at all times.  If any of your compliance items lapse, it may cause the suspension and/or termination of your placement.
  •  - -

  • Terms and Conditions

    I confirm that the information given in this application is, to the best of my knowledge, true I am permitted to work in the UK. I understand that my registration is subject to the receipt of at least two satisfactory references and an enhanced disclosure from the Disclosure and Barring Service (DBS). I undertake to inform Gevic Care Agency Ltd. Should I be convicted of an offence in the future. I undertake to inform Gevic Care Agency Ltd. Immediately if I am engaged through their introduction, including the offer of permanent employment following a temporary assignment. I am clear that Gevic Care Agency Ltd. Cannot guarantee assignments and that they have no responsibility to pay for hours not worked no matter the situation. I have read, understood and agree to the conditions of work for temporary staff, of which I have been given a copy.
  •  - -
  • Should be Empty: