Application Form Fill in the Application Form We are delighted you are considering TEF Social Care Services for your next career move. Please complete the application form below. Application FormTEF Social Care Services Application FormPlease complete all sectionsPlease enter the position you are applying for1 Personal DetailsFirst NameLast NamePrevious NamesEmailPhone NumberAddressAddress Line 1Address Line 2CityPostcodeNational Insurance NumberAre you a citizen of the UK?– Select –YesNoDo you need a work permit?– Select –YesNoCurrent driving licence?– Select –YesNoDo you have a car for work use?– Select –YesNo2 Emergency Contact DetailsFirst NameLast NameAddressAddress Line 1Address Line 2CityPostcodeEmailPhone Number3 Additional Personal DetailsOutside interests, leisure time activities and other personal information which you think may assist us in evaluating your application.4 EducationSchools/FE/HE attendedExamination GradeYear Obtained5 Employment HistoryA full employment history must be detailed beginning with your current employment, and covering all reasons for gaps in any given year.Date From – ToEmployer’s namePosition heldSalary & BenefitsReason for leavingDate From – ToEmployer’s namePosition heldSalary & BenefitsReason for leavingDate From – ToEmployer’s namePosition heldSalary & BenefitsReason for leavingDate From – ToEmployer’s namePosition heldSalary & BenefitsReason for leavingDate From – ToEmployer’s namePosition heldSalary & BenefitsReason for leaving6 Rehabilitation Of Offenders Act 1974 – Notice To OffendersBecause of the nature of the work involved, the post for which you are applying is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Offenders Act (Exemption Order 1975). This means that you are not entitled to withhold information relating to any convictions you may have had.Do you have any convictions to disclose? – Select –YesNoAny information should be given here. This information will be treated as confidential and will not necessarily preclude you from employment. Failure to declare or the falsification of any of the above details will result in the withdrawal of any job offer.7 Equal Opportunities MonitoringThis section of the application will be detached and used for monitoring purposes only. Our organisation recognise and actively promote the benefits of a diverse workforce and are committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation religion or belief. We welcome applications from all sections of the community.Date of BirthGender– Select –FemaleMaleNon BinaryPrefer Not To SayI would describe my ethnic origin as:– Select –Asian or Asian BritishBlack or Black BritishMixed RacedWhiteOther Ethnic GroupI do not want to disclose thisAsian or Asian British– Select –BangladeshiIndianPakistaniAny other Asian backgroundBlack or Black British– Select –AfricanCaribbeanAny other Black backgroundMixed Raced– Select –White & AsianWhite & Black AfricanWhite & Black CaribbeanAny other missed backgroundWhite– Select –BritishIrishAny other white backgroundOther Ethnic Group– Select –ChineseAny other ethnic groupPlease select the option which best describes your sexuality:– Select –LesbianGayBisexualHeterosexualI do not wish to disclose thisPlease indicate your religion or belief:– Select –AtheismBuddhismChristianityIslamJainismSikhismJudaismHinduismOtherI do not wish to disclose this8 Health QuestionnaireIn order to comply with the Health and Social Care Act 2008 and the Equality Act 2010, please complete this questionnaire as fully as possible. Failure to do so could impede or delay your appointment. All information is confidential.Please indicate if you have ever suffered from any of the following. Select as many as applicable. If none, leave blank.Epilepsy/BlackoutsNervous Mental DisordersMigraine/HeadachesSensory ImpairmentSkin AllergiesBack pain/Previous Back InjuryHeart ConditionAsthmatic or respiratory ailmentsRecurring Incidence of IllnessNone of the aboveAre you registered disabled?– Select –YesNoIf yes, please detailPlease list below any periods spent outside of the United Kingdom as a resident (do not include holidays)Please list below any vaccinations or immunisations:DateImmunisationExpiryI declare that the information given is correct to the best of my knowledge. In my view, I am fit physically and mentally to undertake this post. I understand that omissions or false statements may disqualify me from employment or lead to dismissal. I give the employer the right to investigate all references. I Agree9 ReferencesPlease give the name and address of two referees, one of whom must be your present employer, or your previous employer.Reference 1First NameLast NamePositionTelephone No EmailReference 2First NameLast NamePositionTelephone No EmailNotice Period and HolidaysThis organisation 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 bookedPeriod of notice required in present postEarliest start dateThank you for completing this application form. I confirm to the best of my knowledge that the information I have provided is true and accurateFirst NameLast NamePlease enter today’s date: I consent to have this website store my submitted information so TEF Social Care Services can respond accurately to my application I have read and agree to the Terms and Conditions and Privacy PolicySubmit Application Passionate about making a positive impact
