Careers

Position Applied For: *

Date of Application: *

PERSONAL DETAILS

TITLE*

Mrs

Miss

Other

Surname: *

First Names: *

Address: *

Maiden Name: *

Post Code:

Contact Telephone No: *

National Insurance Number

Nationality *

Do you have the right to work in the UK? *

YES

NEXT OF KIN

Surname: *

First Names: *

Address: *

Maiden Name: *

Post Code:

Contact Telephone No:

Relationship to You:

Work Telephone No

EDUCATION

Schools *

Qualifications *

Date Left *

EDUCATION (Continued)

College, University, Further Education *

Degrees, Awards, Qualifications *

Date Left *

KNOWLEDGE, SKILLS AND EXPERIENCE

Please tell us why you would succeed in this position, setting out relevant knowledge, skills and experience you have gained from current/previous employment or voluntary/community work. You should also provide any other information that may be of interest and relevant to the position. Please also describe your aspirations and ambitions. Please remember to address the criteria mentioned in the Job Description and or/ Person Specification when completing your application.

REFERENCES

Please give the name of three referees, one of whom should be your present employer.

Name

Status

Address and Telephone No

EMPLOYMENT HISTORY

Date From To

Employers Name Most Recent First

Position Held

Salary & Benefits

Reason For Leaving

MEDICAL HISTORY

Do you have any health or medical conditions that may affect or limit your ability to work in the care industry? For example, blackouts, epilepsy, heart condition, allergies, skin conditions, major operations, alcohol or drug dependency, back problems etc.

If yes, please give details. *

Yes

OTHER INFORMATION

If you consider yourself as having a disability, is there any support you would require to attend an interview? *

Yes

Please specify (eg. Wheelchair, accessible rooms etc)

Are you related to any employee of this agency? *

Yes

Have you applied for any other post in this organisation in the last year? *

Yes

Do you have a criminal record? If yes please give details on a seperate sheet *

Yes

Do you give us permission to carry out a police check? *

Yes

Do you give us permission to check your references? *

Yes

AVAILABILTY

Period of notice required *

Are you legally eligible for employment in the UK? *

Yes

Date available for work *

Do you hold a current driving licence? *

Yes

Do you require a work permit? *

Yes

Do you require a work permit? *

Yes

Upload Supporting documents.

(CV, Passport & Residence Permit).

Upload *

Maximum file size: 10 MB

DECLARATION

I declare that the information I have given in this application is to the best of my knowledge and as accurate as it can be. For me to knowingly give false information will disqualify me from working for Rex Care Ltd. *

Agree

Digital Signature: *

Maximum file size: 5 MB

Date *

Please fill out the form for Job Application

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