Application Form
Please ensure that you complete the application form in full. This form will be kept in confidence. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural/religious/political beliefs, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. If you have any special requirements to support you to complete this form (e.g. the need for large print or additional time) please contact the Registered Manager.
Position applied for:
Please Select
Care Assistant
Preferred employment type?
Please Select
Full Time
Part Time
How many hours are you looking for?
What availability do you have?
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Every other Saturday
Every other Sunday
Start Time
Finish Time
Start Time
Finish Time
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
County
Post Code
Telephone Number
-
Area Code
Phone Number
Mobile Number
-
Area Code
Phone Number
Email
example@example.com
Do you Drive?
Please Select
Yes
No
Driving Licence Number
How long has your licence been held?
Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National (please circle)?
Please Select
Yes
No
If no, please detail current immigration status and the relevant visa currently held (including Visa number):
National Insurance Number:
Are you are related to a member of staff or Service User at Ray of Sunshine Care Agency, please circle only:
Please Select
Yes
No
Equality Act 2010
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 (http://www.gov.uk/defi nition-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?
Please Select
Yes
No
Prefer not to discuss
Education
Education, Please click on Add Row to add more
Training Courses Attended or Completing
Training Courses Attended or Completing
Employment History
Please record below the details of your full employment history beginning with your current or most recent first. Use a separate attached sheet if required; please sign the sheet(s).
Employment History (please click on Add Row to add more)
Please detail here any gaps in employment and state why:
Supporting Statement
Please add here your reasons for applying. You should refer to the job description and person specification to guide you. It would also be of value to describe particular strengths and talents that set you apart from others as well as including skills gained from work, home and other activities.
Referees
You must provide references from your two most recent employers. Please provide a character reference if you are unable to obtain two professional references, e.g. in the case of an applicant who has been raising children for ten years. All will be contacted, therefore please inform the referees of the fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.
Referees
Safeguarding
Ex-Offenders DeclarationPlease note this section will only be seen by those involved in the recruitment process and will be treated with the strictest of confidence.
Rehabilitation of Offenders Act 1974
Ray of Sunshine Care Agency 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. Ray of Sunshine Care Agency 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?
*
Yes
No
Do you have any current UNSPENT police cautions, reprimands or final warnings in the United Kingdom or in any other country?
*
Yes
No
Privacy
Ray of Sunshine Care Agency will only collect data for specified, explicit and legitimate use in relation to the recruitment process. By signing this application form, you consent to Ray of Sunshine Care Agency holding the information contained within this application form. If successfully shortlisted, data will also include shortlisting scoring and interview records. We would like to keep this data until the vacancy is filled. (We cannot estimate the exact time period, but we will consider this period over when a candidate accepts our job offer for the position for which we are considering you). When that period is over, we will either delete your data or inform you that we would like to keep it in our database for future roles. We have privacy policies that you can request for further information. Please be assured that your data will be securely stored by the Registered Manager and only used for the purposes of recruiting for this vacant post. You have a right for your data to be forgotten, to rectify or access data, to restrict processing, to withdraw consent and to be kept informed about the processing of your data. If you would like to discuss this further or withdraw your consent at any time, please contact the Registered Manager or on.
I agree to have £63.00 deducted for my DBS from my pay as a penalty or from any other source available to my employer if my employment is terminated for any reason within my probationary period by either party.I understand that this is a relevant provision of my contract and that if insufficient remuneration is due to me from my employer, civil court action may be taken to recover any outstanding debt.
Please Select
Yes
No
Declaration
The information in this application form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by Ray of Sunshine Care Agency. Where applicable, I consent that Ray of Sunshine Care Agency can seek clarification regarding professional registration details.
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Signature
C.V or any supporting Documentation
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