Position applied for*
National Insurance No.
Do you need a permit to work in the UK? YesNo
Under section 8 of the Asylum and Immigration act 1996 (amended 1st May 2004) all applicants must provide Employers with evidence of their right to work in the UK. This may take the form of one document from Section 1 or two documents from Section 2 (see back page).
Successful candidates will be asked to provide such information upon the offer of employment.
Additionally, prospective employees will be asked to complete a medical questionnaire.
Educational Qualifications with Dates Achieved:
Professional Qualifications with Dates Achieved:
Training Completed with Dates Completed:
Do you hold a full driving licence? YesNo
Do you have any penalty points? YesNo
If so for what reason?:
Do you own a car? YesNo
Has your licence ever been revoked? YesNo
If so why?
Have you ever been convicted of an offence? (This includes any spent convictions which might otherwise be considered 'spent' We are exempt from Section 4 of the Rehabilitation of Offenders Act 1974) This does not include minor motoring offences.
Name and address of Present Employer:
Present Salary/ Wage:
Employed from / to:
A full employment history must be given. Dates should be consecutive and any gaps explained.
Employers name & address:
Dates from / to:
If 'yes' give details:
Please comment on how you feel you match up to the requirements specified in the Job Description and Person Specification, giving specific examples of any skills, abilities and achievements where relevant.
(Please feel free to give examples not only from work but also from family / home responsibilities, leisure or voluntary activities, education or training if these are appropriate).
Support Worker (Wake Nights) from £7.60 p/h (24 Hrs Total/wk)
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