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Vacancy Details

Personal Details

If you require any adjustments for the interview, please detail them below.
Education and Training

Employment History
• If you are applying in Wales you must provide a full employment history.
• If you are applying in England you must provide a 10 year employment history.
• Dates must be provided in months and years.
• Any gaps in employment must be listed and reasons why.
• If you were in full time education during the last ten years please state and include dates

Current Employer's Contact Details

Previous Employer’s details 1

Previous Employer’s details 2

Previous Employer’s details 3

Previous Employer’s details 4

If you have been unable to account for the required employment history above, please use the box below to provide any further information.

What date are you avalible to start work?

• We require a minimum of 2 references, 1 of which needs to be your most recent employer.
• If you are unable to provide your most recent employer as a reference please provide a reason why, provide your next most recent employer and also a third reference below which must be another employer or professional.
• Your personal must not be a relative.

Reference One - Employment Referee

I was unable to provide details of my present or last employer as a reference because:

Reference Two - Personal Referee

Reference Three - Employment or professional Referee

Can we contact your references as part of the application process*?

Disclosure & Barring Service
This post is subject to a satisfactory Disclosure and Barring Service check, which will reveal all cautions, reprimands, warning, and convictions. In addition to completing this application, you are required to provide us with the details of all spent and unspent convictions. Please send this information to us under separate, confidential cover to the HR Department at: Evolve House, Hung Road, Bristol, BS11 9XJ. Remember to include your name, address and the position for which you are applying and the name of the Care Home. We guarantee that the information you provide will be used fairly, and will only be shared with those necessary as part of the recruitment process. A criminal record will not necessarily bar you from the advertised position; this will depend on the nature of the position and the circumstances and background of your offences. However, failure to reveal this information could lead to the withdrawal of an offer of employment or dismissal.

Please read carefully and tick as appropriate:
I declare that, I,
Do not have, nor have ever had a criminal conviction, nor have been subject to any conditional discharge, bindovers or cautions. (for this purpose no past criminal convictions can be treated as spent).Have a criminal conviction and/or have been subject to any conditional discharge, bindovers or cautions and have confirmed all relevant details.
I clearly understand that in case of this declaration being found to be false your employment with the Company will be terminated immediately.

The Immigration and Asylum Act 1996
Do you require a work permit/visa to be employed in the UK?
Please note: all candidates who are invited for interview will be asked for documentary proof of right to be employed in the UK. A list can be provided by the administrator of acceptable documents.

Refer a friend
Have you been referred by a member of our team?

If yes, please state who.

Other information
Please indicate how you found out about this vacancy.
Advertisement (please state the name of the publication below)Websites (please identify the name of the website below)Other (please state where e.g. Job Centre below)

I certify that the information detailed is correct and understand that false or withheld information may lead to the termination of employment. I acknowledge that any offer of employment is subject to satisfactory references, police check and medical record.

By submitting this application I am in effect signing this declaration.

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