Employment Application Form: Position Applied For

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Employment Application Form

POSITION APPLIED FOR


_______________________________________________
THE FOLLOWING INFORMATION WILL BE TREATED IN THE STRICTEST CONFIDENCE

Personal
Surname

First Name(s)

Address

How long have you lived at this address?

______ Years

______ Months

Private Tel. No.

Mobile No.

Date of Birth.

Do you hold a UK passport?

YES

NO

Do you have a bank account?

YES

NO

National Insurance Number.


Full Driving Licence

YES

NO

Do you have any driving endorsements?

YES

NO

If YES how many points?

Are you involved in any activity which might limit your availability to work or your working hours?

YES

NO

YES

NO

If YES, please give full details.

Are you subject to any restrictions or covenants which might restrict your working
activities?
If YES, Please give full details

You are required as part of your Application to complete the attached Pre-Employment
Medical Questionnaire.
Are you prepared to undergo a medical examination prior to employment if required?

YES

NO

Have you either applied for employment with The Glade before or worked for The Glade?

YES

NO

Are you related to any person employed at The Glade?

YES

NO

If YES, please give details.


Do you need a work permit to take up employment in the UK?

YES

NO

Personal cont.
Are you willing to work overtime and/or weekends if required?

YES/NO

Please give details of any hours which you would not wish to work.

Working with Vulnerable People


All employment at The Glade is subject to an Enhanced Disclosure from Disclosure Scotland. Only persons
with a suitable Enhanced Disclosure will be employed by The Glade.
Have you any convictions (other than spent convictions under the Rehabilitation of
Offenders Act 1974)?

YES/NO

If YES, please give full details

Are you registered with the SSSC or any other relevant regulatory body?

YES/NO

If YES, please give full details

Employment History
Please fill in all of your employment history since leaving school. If extra space is required, attach an A4
sheet with the extra information on it. Any gaps in time should be explained (e.g. child birth, year out etc.).

Employer

start date

leaving date

start date

leaving date

start date

leaving date

start date

leaving date

Position and responsibilities of employment

Reason for leaving


Employer
Position and responsibilities of employment

Reason for leaving


Employer
Position and responsibilities of employment

Reason for leaving


Employer
Position and responsibilities of employment

Reason for leaving

Employment History
Employer

start date

leaving date

start date

leaving date

Position and responsibilities of employment

Reason for leaving


Employer
Position and responsibilities of employment

Reason for leaving

Academic & Leisure History


List below all your qualifications and where you achieved them (if you are invited for an interview you will
be asked to bring along the certificates).
Also list any achievements or training courses you have accomplished/completed, but which do not provide
a certificate.

List below all the schools, colleges and universities you attended in order with approximate dates.
School, college or university

Start date

Finish date

Academic & Leisure History cont.


List below your Hobbies, Interests, Activities & Sports.

Give details below of any personal qualities, skills or experiences that are relevant to the job advertised.

References
Please give the names of two people (one of which should be your present or most recent employer) whom
we may approach for a reference. References will not be accepted from family members or from people writing solely in the capacity of friends.
Name:

Name:

Position:

Position:

Address:

Address:

Tel. No.

Tel. No.

Declaration
I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable to summary
dismissal and relevant information will be passed on to the SSSC.
Signature: (can be signed when interviewed)

Date:

Please return completed electronic application form to Chris at email:- [email protected]


Post paper forms to Mrs. Claire Curnin
The Glade Care Home, 22 North Latch Road, Brechin, DD9 6LE.
If you have any questions or queries about a vacant position or completing this form please call
01356 623166 and ask for Claire Curnin or Chris Curnin

Submit

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