Emergency Contact

In case of emergency please notify:

the company will require proof of this right before an offer of employment can be confirmed – e.g. Birth certificate and/or any other appropriate document required to confirm your right to work in the UK as required by the Asylum and Immigration Act 1996

EDUCATION

AVAILABILITY

Please complete all areas of availability:

REFERENCES

Please give the details of two work related referees, including your current or most recent post. Referees will not be contacted without your prior approval

reference 1

reference 2

DECLARATIONS- CRIMINAL CONVICTIONS

All workers of 1ST CARE LTD are subject to the Health and Social Care Act 2008, and will be subject to a Police Record Check through the DBS. Please declare all criminal convictions, whether spent or not, charges, whether proceeded with or not, and warnings and cautions. You will not be eligible for work in a Care setting if you are not on the DBS Register or don’t have a current DBS (APPLICABLE FOR CANDIDATES WHO HAVE APPLIED FOR CARE RELATED ROLES). A criminal record will not necessarily be a bar to obtaining a position at 1ST CARE 4U LTD. If a check is returned and reveals any information this will be discussed with the applicant and a risk assessment will be completed.

Rehabilitation of Offenders act 1974 (exceptions)(amendment) order 1986

We would draw your attention to the following statement:- “Because of the nature of the work for which you are applying, this post is not exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act, 1974, by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 and the Rehabilitation of Offenders 1974 (Exceptions) (Amendment) Order 1986. Applicants are, therefore, not entitled to withhold information about convictions which for other purposes are ‘spent’ under the provisions of the Act”.

NEW STARTER DECLARATION

Starter declaration 

Tick one of the following three statements:

Student Loans I make:

Statutory information – Bank Details

The Working Time Regulations Act 1998 (the regulations) require the company to limit your
average weekly working time to 48 hours unless you agree with the company that the limit shall
not apply to you
The company wishes to have an agreement with you. It proposes an agreement (which shall apply
until terminated by notice) on basis that:
1) The 48-hour limit on average weekly working time will not apply to you.
2) You may terminate the agreement (so that the 48-hour time limit would not apply to you) by
giving the Branch manager one-week written notice. For avoidance of doubt, any notice
bringing this agreement to and shall not be construed as termination by the employee of
his/her employment with 1st care 4u ltd.
Under the regulations, the company must keep records relating to your working time. This is the
case whether or not you reach an agreement with the company about waiving working time limits.
If you accept the company’s proposal, please sign on the form provided. This document will not be
a record of agreement between you and 1st care 4u ltd.