You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
You Are Here: Introduction About You/Education Employment References/Comments Health Review/Submit
Cumbria View Care Services Ltd

Application For Employment

Thank you for choosing to submit an application for employment to Cumbria View Care Services Ltd.

Please complete the form as fully as possible.  You will be able to move backwards and forwards through the pages of the form, and you will be given a chance to review your form before you submit it.

If you wish to download a PDF version of this form so that you can see what information is needed before you begin the application procedure please click here.

Your information will not be stored online, but will be sent to our offices immediately once you have finished filling in all sections.

To begin Click here:

APPLICATION FOR EMPLOYMENT

PRIVATE AND CONFIDENTIAL
      Ref.No:
         
POSITION APPLIED FOR:  
Surname:   Forename(s)   Title
Address:  
Postcode:  Telephone: 
  Email:  
NI No.     
Current driving licence?   Yes  No  Details of endorsements:  
Groups:      Expiry Date:    
Are there any restrictions on you taking up employment in the UK?    Yes  No    (if yes, please provide details at the end)

EDUCATION HISTORY

Schools Qualifications gained:
Colleges/Universities: Qualifications gained:
Other Training:  

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OTHER EMPLOYMENT

Please note any other employment you would continue with if you were successful in obtaining this position:

EMPLOYMENT HISTORY    (Please complete in full and add extra information at the end of the form if necessary)

Name & Address of Employer Job Title and Duties Rate of Pay Reason For
Leaving
Notice required in current post:  

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REFERENCES

Please note here the names and addresses of two persons from whom we may obtain both character and work experience references.

1. 2.

LEISURE

Please note here your leisure interests, sports and hobbies, other pastimes etc.

CRIMINAL RECORD

Please note any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974. If none please state. In certain circumstances employment is dependent upon obtaining a satisfactory basic disclosure from the Criminal Records Bureau/Scottish Criminal Records Office.

GENERAL COMMENTS

Please detail here your reasons for this application, your main achievements to date and the strengths you would bring to this post. Specifically, please detail how your knowledge, skills and experiences meet the requirements of this role (as summarised in the person specification). 

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HEALTH DETAILS

Do you have any physical or mental impairment which has a substantial and long term effect on your ability to carry out day to day activities?   
Yes  No 

Please specify any special arrangement for work associated with any impairment.


Please specify any special arrangements you will need to attend an interview.
Please list any diseases, disorders, allergies, muscular or musculoskeletal injuries from which you have suffered or do suffer.
Please detail any form of medicine, drugs or treatment you are currently and/or regularly receiving.
Please list all absences from work in the past 12 months and the reasons for such absences.

DECLARATION (Please read this carefully before signing this application)

  1. I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.
     
  2. I agree that the organisation reserves the right to require me to undergo a medical examination. (Should we require further information and wish to contact your doctor with a view to obtaining a medical report, the law requires us to inform you of our intention and obtain your permission prior to contacting your doctor). I agree that this information will be retained in my personnel file during employment and for up to six years thereafter and understand that information will be processed in accordance with the Data Protection Act.
     
  3. I agree that should I be successful in this application, I will, if required, apply to the Criminal Records Bureau/Scottish Criminal Records Office for a basic disclosure. I understand that should I fail to do so, or should the disclosure not be to the satisfaction of the company any offer of employment may be withdrawn or my employment terminated.
     

I have read the above declaration and I agree to be bound by it: 
Date:

BACK | Review your application and add additional information

ADDITIONAL INFORMATION

Please any information you were unable to supply above such as restrictions on working and additional employment details:

Please check all of the information you have entered above and then click SUBMIT to submit your application.

© 2012 Cumbria View Care Services Limited
16c Market Place, Kendal, CUMBRIA, LA9 4TN