Application Form

Application Form
Personal Details
Name

First Name Last Name
Have you ever been known by another name?

First Name Last Name
E-mail
example@example.com
Phone Number

Area CodePhone Number
Service Applied for
Position Applied for
Do you have a full valid UK driving license ?
If you have answered yes please provide how long you have held this for.
Safeguarding

Your employment is subject to a satisfactory disclosure and barring check from the Disclosure and Barring Service (DBS) in accordance with the Rehabilitation of Offenders Act 1974 and the Police Act 1997.
Are you currently subject to any criminal charges?
If Yes details should be given in a sealed envelope marked “Private and Confidential” –and brought to interview and handed to the HR Manager.

If successful, you will be required to provide the appropriate documentation to allow an Enhanced DBS check to be completed.
DBS update system
If you have a DBS on the update system, please provide your certificate number starting with a 0 and your date of birth.
Address
Address 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long have you lived at this address ?
If you have lived at the above address for less than 3 years please provide the one prior to that.
Address 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long have you lived at this address ?
Right to work
Are there any restrictions around your right to work in the UK? (Visa, Sponsorship) if so please provide information below.
Employment History:
Have you ever worked for Action for Care before?
Please include ALL employment / education to over a minimum of the past 5 years starting with the most recent first. Please give an explanation of any periods when you were not in employment, education or training. Please note that if this is left empty we cannot accept your application form.
Current Employer
Name of Current Employer or NONE if not Employed
Position
Start date
Finish date
Reason for leaving
Previous Employer
Position
Start date
Finish date
Reason for leaving
Previous Employer
Position
Start date
Finish date
Reason for leaving
Previous Employer
Position
Start date
Finish date
Reason for leaving
Previous Employer
Position
Start date
Finish date
Reason for leaving
References
Can we approach your current employer before an offer of employment is made?
Please provide a minimum of 2 professional references that cover the past 3 years of employment. One must be your most recent employer.
Employer company name
Name

First NameLast Name
Relationship to you
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
We can also accept a character reference from someone who has known you for a number of years or has previously worked alongside you.
Name

First NameLast Name
Relationship to you
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Education History

Type a question

Rows	School/College/Universtiy	Subject Studied	Year	Grade
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Do you have any other relevant qualifications or experience for this role?
Declaration

I declare that, to the best of my knowledge and belief, theinformation given on ALL parts of this form is to the best of my knowledge complete and correct. I understand that, should my application besuccessful, any false, incomplete or misleading statements may lead todismissal.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I declare that, to the best of my knowledge and belief, the information given on ALL parts of this form is to the best of my knowledge complete and correct. I understand that, should my application be successful, any false, incomplete or misleading statements may lead to dismissal.
CV Upload

Cancelof
Should be Empty:

Application Form

Personal Details

Safeguarding

Address

Right to work

Employment History:

References

Education History

Declaration