JOB APPLICATION Job Application Form Select position you're applying for (If no position is displayed, please check again later for vacancies) No Vacancies. Please check back later Title Mr Mrs Miss Ms Other Your Full Name (As on valid ID) Your Address Postcode Your Phone Number Email Address Do you have valid proof of Right to Work in the UK? Yes No UK Driver's Licence Full Provisional None Do you have regular access to a car? Yes No Do you have any driving-related prosecutions / fixed penalties / endorsements or similar currently pending? Yes No If "Yes", please provide brief details Have you ever been disqualified from driving? Yes No If "Yes", please provide brief details Have you ever had insurance refused? Yes No If "Yes", please provide brief details Please enter any relevant qualification or professional training received. (Please include dates, institutions attended and qualifications gained) Employment History (Please enter any relevant job experience. Please include dates worked from/to, previous employer, position held and reason for leaving) Your availability Full-time Part-time Shifts Please provide brief detail of any planned holidays References (Please provide names, positions, email addresses and contact numbers of 2 referees who we may approach with regards to this Job Application. These referees must not be members of your family, and one must be your present or most recent employer) May we contact your referees prior to making a job offer? Yes No If the position you are applying for (whether paid or voluntary) is listed in Schedule 1, Part II of the Rehabilitation of Offenders Act (Exceptions) Order 1975, we are entitled to ask Exempted Questions as defined by Section 113(5) of the Police Act 1997 about you. We are required to check a DBS Certificate in relation to any person who is a Care Manager or Care Worker. If your application is successful and before your appointment is confirmed, you will be required to submit a personal current and valid DBS Certificate for our inspection. Having a criminal record will not necessarily bar you from working with us. This will depend upon the nature of the position and the circumstances and background of your offences. We observe the “Code of Practice for Registered Persons and Other Recipients of Disclosure Information” published through the Disclosure & Barring Service on behalf of the Home Office, and we will provide you with a copy of it upon request. I agree ANY PERSON, UPON SUBSEQUENT EMPLOYMENT, THAT IS FOUND TO HAVE KNOWINGLY SUPPLIED FALSE OR MISLEADING INFORMATION, OR HAS DELIBERATELY WITHHELD RELEVANT INFORMATION, MAY BE SUBJECT TO DISCIPLINARY PROCEEDINGS WHICH MAY RESULT IN DISMISSAL. I have read and understood the information supplied to me in relation to this Job Position, and the information requested in this Job Application Form. I confirm that all information supplied by me is true and correct to the best of my beliefs. I give the prospective employer the right to follow up all references and to make any other job-related enquiries as may be deemed necessary. Yes GDM SOCIAL CARE LTD IS AN EQUAL OPPORTUNITIES EMPLOYER. The sole criterion for selection of applicants will be suitability for the Job Position, regardless of gender, background, culture, ethnic denomination, religious affiliation, marital status or disability. Data Protection Act 1998: By submitting this application, you give us authorisation, under the Data Protection Act 1998, to process the information you have given, including data of a sensitive nature, relating to your application for employment. Any processing of the data by us will be in accordance with our Policy and the processing principles set out in the Act. Application forms of unsuccessful candidates will be destroyed after 6 months in accordance with our Record-keeping Policy. I agree
