CASTLEOAK CARE PARTNERSHIPS LIMITED

APPLICATION FOR EMPLOYMENT

Post Applied For: / Employment
Part Time/Full Time*
If you know anyone working in this company please give their name:
How did you hear about this vacancy?

Please complete clearly in Block Capitals using black/dark blue ink. * Please circle where appropriate

1. PERSONAL DETAILS

The following 3 pages will be separated from your application before assessment takes place.
Surname: / Title: Mr/Mrs/Miss/Ms*
Forenames:
Full Postal Address (inc Postcode):
Would you have to move home if offered this job? / Yes/No*
Evening telephone number: / Mobile telephone number:
Daytime telephone number: / E-mail address:
Please indicate your preferred method of contact should you be invited for interview.
If driving is part of the job you are applying for, please answer the following questions.
Do you hold a full current driving licence?
N.B. You will be required to provide a copy of your driving licence / Yes/No*
Do you have any penalty points endorsed on your current licence? / Yes/No*
If Yes, please provide details:
Type of Endorsement / Points / Date Issued

Criminal Convictions

Have you ever been convicted of a criminal offence (declaration subject to the Rehabilitation of Offenders Act 1974)? / Yes/No*
If Yes, please provide details:

right to work

Do you have any restrictions that may affect your right to take up employment in the UK? / Yes/No*
If Yes, please provide details:
If you are successful in your application, would you require a work permit to work in the UK? / Yes/No*
If Yes, please provide details:

2. Equal opportunities monitoring form

Castleoak is committed to increasing equality and diversity within its workforce. As part of this we need information from applicants to check that our recruitment and selection procedures are reaching as many potential candidates as possible and are fair. The information provided is only used for monitoring purposes, not for selection. All information is provided on a voluntary basis.
Completed forms will be passed directly to the HR Department.
Position Applied For:
Surname: / Forenames:
Date of Birth:
Please tick the appropriate boxes:
Gender: / Female / □ / Male / □
Disabled*: / Yes / □ / No / □ / Unsure / □
Disability Details*:
*Disability is defined as “A physical or mental impairment, which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities.”
My Origin is:
White / □ / Black African / □ / Black Caribbean / □
Black Other / □ / Chinese / □ / Indian / □
Pakistani / □ / Bangladeshi / □ / Asian Other / □
Other / □
Nationality – Please Specify:
Religious Belief:
Would you describe your sexual orientation as?
Heterosexual / □ / Homosexual / □ / Gay / □
Bi-Sexual / □ / Other / □
Marital Status?
Married / □ / Single / □ / Divorced / □
Separated / □ / Co-Habiting / □ / Widowed / □

□ I prefer not to give any of this information.

3. EDUCATION, QUALIFICATIONS AND OTHER TRAINING

Education

School, College and/or University Attended (most recent first)
Name / Address / From / To

Qualifications Achieved

Please give details of any relevant qualifications you hold (most recent first). If your application is successful, we will require proof of these.
Qualification/Subject / Awarding Body / Grade/Level / Date Awarded

Training

Please give details of any training that you feel is relevant to this application (most recent first).
Qualification/Subject / Training Provider / Date Awarded

Professional Associations

Are you a member of any professional institutes?
Professional Body / Level/Grade of Membership / Date Joined

4. WORK RECORD

Please describe all relevant work/experience undertaken, paid and/or voluntary you have done, starting with your most recent activities first. Please show dates, your role and responsibilities and the organisation.

Current/Most Recent Employer

Position Held: / Date Appointed: / Date Left:
Organisation:
Address:
Responsible to: / Number Reporting Directly to You:
Reason for Leaving (if applicable): / Final Remuneration:
Please give a brief description of the main responsibilities, knowledge and experience gained.

Previous Employment

Position Held: / Date Appointed: / Date Left:
Main Duties:
Organisation:
Address:
Responsible to:: / Number Reporting Directly to You:
Reason for Leaving: / Final Remuneration:
Please give a brief description of the main responsibilities, knowledge and experience gained.
Position Held: / Date Appointed: / Date Left:
Main Duties:
Organisation:
Address:
Responsible to:: / Number Reporting Directly to You:
Reason for Leaving: / Final Remuneration:
Please give a brief description of the main responsibilities, knowledge and experience gained in your current/most recent post.
Position Held: / Date Appointed: / Date Left:
Main Duties:
Organisation:
Address:
Responsible to:: / Number Reporting Directly to You:
Reason for Leaving: / Final Remuneration:
Please give a brief description of the main responsibilities, knowledge and experience gained in your current/most recent post.

5. YOUR SKILLS AND EXPERIENCE

Please provide specific examples of how your skills and experience meet the requirements of the post applied for (refer to the full person specification for examples of the kind of evidence we are looking for). Your evidence should not exceed more than one page of A4. You should also detail any other information you consider appropriate.
Hobbies/Interests:

6. GENERAL

When would you be available for interview?
Current Notice Period?
Do you have any holiday commitments?
Please give details of any part-time or other commitments that might limit your working hours?

References

Please provide details of two referees we may approach to check the factual information in your application. Wherever possible, one referee should be your most recent/last employer.
Name: / Name
Occupation: / Occupation:
Organisation: / Organisation:
Relationship: / Relationship:
Address: / Address:
Telephone Number: / Telephone Number:

Declaration

I confirm that the above information is correct and understand that misleading statements may be sufficient grounds for cancelling any agreements made. I also understand that questions left unanswered may be discussed at interviews arising from this application.
Applicant Signature: / Date:

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