Employment Application Form

1st Homecare Employment Application Form

Job Post Details

Job Title *

Position applied for

Job Location *

Personal Details

Name *

First

Last

Previous (Or other name) *

First

Last

Preferred Name

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

National Insurance Number *

Daytime Telephone Number *

Evening Telephone Number *

Your Email Address *

PVG Scheme Number *

SSSC Registration Number *

Current Driving Licence *

Full Driving Licence
Provisional Driving Licence
No Driving Licence

Please select the option that applies to you.

Do you have any motoring convictions? *

Please select the option that applies to you.

General Information

Have you been employed by 1st Homecare before? *

Do you wish to apply for a full-time post? *

Do you wish to apply for a part-time post? *

To the best of your knowledge, are any relatives or family members employed by Real Life Options or 1st Homecare?

Education

Please give details of any education, technical and/or professional qualifications. If you are currently studying please provide details of the qualifications you are studying for.

Examination/Qualifications taken or to be taken

Please list examinations to be taken / qualifications obtained, subject, results & grades.

Name of Awarding Body

Date Obtained

Training / Job Related Training Undertaken In The Last 5 Years

Please list any course(s) which you have undertaken that are relevant to the job and/or specified on the person specification. Eg. Further and Higher Education (Degree, Diploma, BTEC, City & Guilds, NVQ etc)

Training Details *

Please list course title, length of course, and certificates / qualifications gained.

Date Obtained *

Membership

Please list membership of any organisation(s) relevant to the job.

Membership details *

Please provide name of organisation, type of membership and if the membership is current.

Skills, Abilities, Experience and Achievements

Please give details of your skills, abilities, achievements and experience (Including outside interests) and use examples to demonstrate how you meet each of the criteria listed in the person specification. (State who provided training and duration of training) Examples could include: short courses, skills training, external awards/activities etc

Please provide as much detail as possible. *

Present Or More Recent Employment

Present Employers Name (Company)

Line Managers Name & Job Title

Your Job Title

Hours Worked

Present Salary

Present Company Benefits

i.e Company Car, Employee Health Scheme etc.Write N/A if not applicable

Notice Period Required

i.e 2 weeks, 4 weeks, 6 months etc.

Nature Of Post

Please describe your main duties

Why Are You Looking To Leave This Employment?

Please provide as much detail as possible.

Will you continue in any other employment should you be offered this appointment?

Posts working with Children, Young People and Vulnerable Adults

If applying for a post which involves working with children, young people and vulnerable adults, you are required to provide below the dates you were employed from and to, and provide details of any gaps in your employment.

Employment Dates with Employer (1) *

from DD/MM/YYYY to DD/MM/YYYY

Previous Employer Company Name (1) *

Address Of Previous Employer (1) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Position Held With Previous Employer (1) *

Brief Description Of Duties *

Reason For Leaving This Employment *

Please Check This Box If You Require To Add Additional Previous Employer Details

I Require To Add Additional Previous Employment Details

Employment Dates with Employer (2)

from DD/MM/YYYY to DD/MM/YYYY

Previous Employer Company Name (2)

Position Held With Previous Employer (2)

Brief Description Of Duties

Reason For Leaving This Employment

Please Check This Box If You Require To Add Additional Previous Employer Details (2)

I Require To Add Additional Previous Employment Details

Previous Employer Company Name (3)

Employment Dates with Employer (3)

from DD/MM/YYYY to DD/MM/YYYY

Position Held With Previous Employer (3)

Brief Description Of Duties (3)

Reason For Leaving This Employment (3)

Please Check This Box If You Require To Add Additional Previous Employer Details (3)

I Require To Add Additional Previous Employment Details

Previous Employer Company Name (4)

Employment Dates with Employer (4)

from DD/MM/YYYY to DD/MM/YYYY

Position Held With Previous Employer (4)

Reason For Leaving This Employment (4)

Please Check This Box If You Require To Add Additional Previous Employer Details (5)

I Require To Add Additional Previous Employment Details

Previous Employer Company Name (5)

Employment Dates with Employer (5)

from DD/MM/YYYY to DD/MM/YYYY

Position Held With Previous Employer (5)

Reason For Leaving This Employment (5)

Please Check This Box If You Require To Add Additional Previous Employer Details (6)

I Require To Add Additional Previous Employment Details

Previous Employer Company Name (6)

Employment Dates with Employer (6)

from DD/MM/YYYY to DD/MM/YYYY

Position Held With Previous Employer (6)

Reason For Leaving This Employment (6)

Personal Statement

The information you provide in this section will be used in assessing your application for this post. A decision about if to interview you will be largely based on this statement. Outline your reasons for applying for this post and give your views on this area of work and client group.

(a) How you meet the Person Specification? *

(b) Explain what attracted you to this post and why you have applied for the post? *

(c) Describe the qualities you have which you feel make you suitable for the position you are applying for. Include any skills, knowledge or experience relating to the requirements of the post. *

Job References

Written references will be needed for any candidatewho is successful at interview. Please ensure your referees are aware of this, and are happy to provide this information. Referees will be asked for information on disciplinary issues, sickeness and absence. Please give details of two people whom you are not related and to whom a request for reference can be made.

Please note that your present or last employer should be given as your first reference.

Details Of Referee (1)

Name Of Referee (1) *

Occupation Of Referee (1) *

Address of Referee (1) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Tel No of Referee (1) *

Email Of Referee (1) *

Details Of Referee (2)

Name Of Referee (2) *

Occupation Of Referee (2) *

Address of Referee (2) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Tel No of Referee (2) *

Email Of Referee (2) *

Disclosure of Criminal Records

Because of the nature of some posts it is important that you complete this section carefully and accurately. Applicants for posts working with or having access to Vulnerable Adults are subject to an enhanced disclosure through the Criminal Records Bureau (England) or Disclosure Scotland (Scotland). Because the position for which you have applied may be covered by the Rehabilitation of Offenders Act 1974 and the Care Standards Act 2000, you are required to disclose all convictions and cautions no matter how long ago they occurred and regardless of whether the offence was committed a s a juvenile or adult.

Do you have, or have you ever had, any convictions, cautions, admonishments, reprimands or final warnings *

Are you currently the subject of criminal proceedings or police investigation *

Disclosure Scotland

Job posts within 1st Homecare involve working with vulnerable groups. Applicants for these posts will be required to complete a Disclosure Scotland Application. *

I have read and understood this statement

Declaration (Please Read Carefully)

The information you provide on this form will be used for the purposes of assessing your suitability for appointment; this may involve contacting referees, previous employers, or educational establishments, to confirm the validity of information provided. If your application is unsuccessful we will dispose of this information in line with our Data Protection and Employment Policies. We will use the information you provide to fulfil our legal requirement to monitor equal opportunities; however, this will be used for statistical purposes only.

I have read this application form fully and I declare that the information I have given in support of my application is, to the best of my knowledge and belief, true and complete. I understand that if it is subsequently discovered that any statement is false or misleading, or that I have withheld any relevant information my application may be disqualified or, if I have already been appointed, I may be dismissed without notice.

Declaration Agreement *

I Agree

By clicking "I Agree" you agree to the declaration above, and that all information submitted is factually correct to the best of your knowledge.

Signature *

By typing your name in this box you are digitally signing this application form.

Application Form Submission Date *

Todays Date

Entitlement to Work in the United Kingdom

To comply with the Asylum and Immigration Act 1996 all prospective employees will be asked to supply evidence of eligibility to work in the UK. We will ask to see an appropriate official document, for example, a document showing your national insurance number, if you have one, your birth certificate, passport etc.

Candidates selected for interview will normally be notified within 4 weeks of the closing date. Unfortunately, applicants who do not hear from us must conclude that their application has been unsuccessful on this occasion. Please note that the information provided may be shared with the Job Centre Plus.

Post Applied For *

Are you able to provide the relevant documentation to prove your eligibility to work in the UK? *

Yes, I can provide documentation
No, I cannot provide documentation

Signature *

By typing your name in this box you are confirming that you are eligible to work in the UK.

Eligibility to Work in the United Kingdom Questionnaire Submission Date *

Todays Date

By signing and returning this form you acknowledge and understand the above legal requirement and that you recognise the restrictions on recruitment with which 1st Homecare is required to follow.

Please note you will be required to produce the documents / declarations required by legislation if short-listed for interview (if requested to do so).

Employment Application Form

Job Post Details

Personal Details

General Information

Education

Training / Job Related Training Undertaken In The Last 5 Years

Membership

Skills, Abilities, Experience and Achievements

Present Or More Recent Employment

Posts working with Children, Young People and Vulnerable Adults

Previous Employment (continued)

Personal Statement

Job References

Details Of Referee (1)

Details Of Referee (2)

Disclosure of Criminal Records

Disclosure Scotland

Declaration (Please Read Carefully)

Entitlement to Work in the United Kingdom

1st Homecare is a care at home provider offering a range of services across Scotland. With branches in Ayrshire, Dumfries, Falkirk and Fife, we’re well placed to serve the growing community of people who need a little extra help to retain their independence in their own homes.

Suite 1, Ground Floor
Academy House
1346 Shettleston Road
Glasgow
G32 9AT

Company Registration No: SC272838

Phone: 0141 778 5193

Monday-Friday:
9:00am – 5:00pm

Employment Application Form

Job Post Details

Personal Details

General Information

Education

Training / Job Related Training Undertaken In The Last 5 Years

Membership

Skills, Abilities, Experience and Achievements

Present Or More Recent Employment

Posts working with Children, Young People and Vulnerable Adults

Previous Employment (continued)

Personal Statement

Job References

Details Of Referee (1)

Details Of Referee (2)

Disclosure of Criminal Records

Disclosure Scotland

Declaration (Please Read Carefully)

Entitlement to Work in the United Kingdom

1st Homecare is a care at home provider offering a range of services across Scotland. With branches in Ayrshire, Dumfries, Falkirk and Fife, we’re well placed to serve the growing community of people who need a little extra help to retain their independence in their own homes.

Suite 1, Ground Floor Academy House 1346 Shettleston Road Glasgow G32 9AT Company Registration No: SC272838

Phone: 0141 778 5193

Monday-Friday: 9:00am – 5:00pm

Suite 1, Ground Floor
Academy House
1346 Shettleston Road
Glasgow
G32 9AT

Company Registration No: SC272838

Monday-Friday:
9:00am – 5:00pm