Apply For A Job

Strictly Confidential

41 Mullard drive
Leamington spa
Warwickshire, CV31 2QE

Telephone: 01926 431925

E-mail: ensurecareltd@gmail.com

Position Applied For(Required)

Date of Application(Required)

1. PERSONAL DETAILS

Preferred Title(Required)

Gender(Required)

First Names(Required)

Surname(Required)

Previous Names

Address(Required)

Postcode(Required)

Email(Required)

Home Telephone No:

Mobile No:

Work Telephone No:

National Insurance Number(Required)

Immigration Details / Status(Required)

Marital Status(Required)

Are you a citizen of the EU?(Required)

Do you need a work permit?(Required)

Do you have UK-full, clean driving licence?(Required)

Do you have a car for work use?(Required)

Preferred location (tick all that apply)(Required)

Leamington Spa

Warwick

Kenilworth

Stratford-upon-Avon

Time(Required)

How many hours per week do you require?(Required)

2. EDUCATION & QUALIFICATIONS

Education & Qualifications(Required)

3. PRESENT / MOST RECENT EMPLOYMENT

Employer’s Name:

Job Title(Required)

Date of appointment

Period of notice required:(Required)

Summary of present duties and responsibilities:(Required)

A full employment history must be detailed beginning with your current employment, and covering all reasons for gaps in any given year.(Required)

4. REHABILITATION OF OFFENDERS ACT 1974 – NOTICE TO OFFENDERS

Do you have any convictions to disclose?(Required)

Failure to declare or the falsification of any of the above details will result in the withdrawal of any job offer.

5. ADDITIONAL PERSONAL DETAILS

Personal statement(Required)

Other Information(Required)

6. REFERENCES

Please give the name and address of two referees, one of whom must be your present employer, or your previous employer. (School or college if a student). Relatives or Partners cannot be accepted as referees

Name(Required)

Tel:(Required)

Address(Required)

Postcode(Required)

Capacity in which the referee knows you:(Required)

May we approach the above prior to interviewing(Required)

Name(Required)

Tel:(Required)

Address(Required)

Postcode(Required)

Capacity in which the referee knows you:(Required)

May we approach the above prior to interviewing(Required)

The nature of this job places you with ‘Vulnerable adults’ therefore all applicants will be expected to have a CRB check, which will cost £51.20, I understand that this declaration will include details of any criminal convictions, cautions, reprimands, final warnings and any other information that may have a bearing on my suitability for this job.

Please state if you are related to any Director or Member of staff of the Company(Required)

If yes, name of that person

Health Record(Required)

Where did you hear about this position?

Ensure Care Ltd. seeks to work in a flexible and family friendly manner with its staff; however unsocial hours are part and parcel of a quality care service. Weekend working is a requirement for all staff, the frequency of which will be determined at interview.

Please indicate holiday dates if already booked

Period of notice required in present post(Required)

Earliest start date(Required)

Thank you for completing this application form.

Date(Required)