Fields marked with an asterisk (*) must be filled out before submitting





    Personal Details



    Contact Details









    Education and Training

    Provide details of education and qualifications obtained from secondary school, further and higher education. Please list place of study, dates between and qualification including grades

    Please give details of any course you have attended or specialist skills training undertaken, please List organising body, dates between and course title / subject

    Please start with your most recent employment and work back, giving reasons for any gaps in your employment, please list dates between, employers name, location and nature of business, and job title including an outline of duties and reasons for leaving – if part-time, state hours worked

    Present Employment, or most recent if unemployed







    Additional Information

    Personal Statement


    Health

    Successful applicants will be required to complete a confidential health questionnaire

    Reference / Contact with present and recent employers

    Please give the name, address, telephone numbers and where appropriate the e-mail addresses of two people who have agreed to act as referees for you. One should be your most recent of present employer with whom contact can be made to verify the details of your present or most recent employment. The person should be in a management or supervisory position. The other should be a recent employer or if you do not have a suitable employment referee please provide the details of a person willing to provide you with a character reference. We will contact both referees prior to interview unless you indicate otherwise

    Referee 1






    Referee 2






    Eligibility To Work In The Uk

    If you are not a British or European Economic Area citizen you may need a work permit to be able to work in the UK. If you are successful in being offered a post, the University can apply for a permit for you but you may not start work without one





    Equal Opportunities

    Orchard Home Care Services Ltd is committed to making its Equal Opportunities policy fully effective. To assist in monitoring this policy please complete this section. This information is not used in selection for the post

    Disability Status: Do you have a disability which fits the definition in the Disability Discrimination Act – a physical or mental impairment which has a substantial and long term (i.e. over at least 12 months) adverse effect on your ability to carry out normal day-to-day activities?

    If you have a disability, and if you were shortlisted, please indicate any reasonable adjustments that would be required for you to attend the interview

    Ethnic Origin: This refers to people who share the same cultural background and identity, not country of birth or nationality. Please note these categories are those used in the National Census.


    Convictions / Cautions

    Successful applicants will require an enhanced Criminal Records Bureau Disclosure. This disclosure does show all cautions and convictions no matter how old they are



    Declaration

    Due to the nature of the work for which you are applying, this is exempt from the provisions of the Rehabilitation of Offenders Act 1974, by virtue of the Rehabilitation of Offenders Act, (exemptions) order 1975. Applicants are therefore not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of the Act and, in the event of employment; any failure to disclose such convictions could result in dismissal or disciplinary action. Any information given will be completely confidential and will be considered only in relation to the application for positions to which the order applies.
    PLEASE READ AND CLICK “I UNDERSTAND” AFTER YOU HAVE COMPLETED ALL PARTS OF THIS FORM I certify to the best of my knowledge that the information given on this form is correct. I understand that deliberately giving false or incomplete information would disqualify me from appointment, or in the event of discovery after appointment, make me liable for dismissal.