Application Form

Contact Us

Position:

Location:

Work Preference:

Full Name:

Maiden Name:

Address:

New Field:

Gender:

Nationality:

If not a British National, please detail your current immigration status and the relevant visa currently held (including Visa number)

Phone Number:

E-mail address:

Are you a driver?

Do you own transport?

Are you related to any of our current members of staff or Service Users?

For the purposes of this application and interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?

Education *(All qualifications will be subject to a satisfactory check).

Training Courses attended or completing (evidence of attending courses is required)

Professional Memberships / Registrations

Start Date:

Field label

Job Role:

Reason for Leaving:

Duties:

Contact Name:

Address:

Telephone:

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Employment History

Please record below the details of your full employment history beginning with your current or most recent first. Any gaps must be explained. Use a separate attached sheet if required; please sign the sheet(s)

Start Date:

End Date:

Job Role:

Employer Name:

Reason for Leaving:

Duties:

Contact Name:

Address:

Telephone:

Email:

New Field:

End Date:

New Field:

Duties:

Address:

Telephone

Email:

Start Date:

End Date:

Job Role:

Employer Name:

Reason for Leaving:

Contact Name:

Duties:

Address:

Telephone:

Email:

Start Date:

End Date:

Job Role:

Employer Name:

Reason for Leaving:

Contact Name:

Duties:

Address:

Telephone:

Email:

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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.

Supporting Statement:

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References:

Please provide names, addresses and telephone numbers for referees below whom we may approach for a reference. In line with CQC requirements, we require references (or other satisfactory evidence as the employer may determine) from all previous employers concerned with the provision of services relating to health or social care, or children or vulnerable adults which should include details of why their employment came to an end (note that this is not time limited). If your previous employment does not concern the provision of services relating to health or social care, or children or vulnerable adults, you must provide references from your two most recent employers.

Please provide two character references 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.

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Referee One

Contact Name:

Business Name:

Address:

Telephone:

Email:

Capacity in which known

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Referee Two

Contact Name:

Business Name:

Address:

Telephone:

Email:

Capacity in which known:

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Additional Referee

Address:

Telephone:

Email:

New Field:

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Safeguarding / Ex-Offenders Declaration: Please note this section will only be seen by those involved in the recruitment process and will be treated with the strictest confidence.

The Rehabilitation of Offenders Act 1974 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. Devotion Intergrated Care 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?

Do you have any current UNSPENT police cautions, reprimands or final warnings in the United Kingdom or in any other country?

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Privacy Statement

We will only collect data for specified explicit and legitimate use in relation to the recruitment process. By signing this application form, you consent to us 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 to discuss.

New Field:

Field label

Date:

Contact Us

CONTACT

info@devotioncareltd.com

ADDRESS

DEVOTION INTERGRATED CARE LTD

CORBY BUSINESS CENTRE

EISMANN WAY

CORBY

NN17 5ZB

OFFICE OPENING HOURS