Job Application Form

* Required

Position Applied for *		Date Available to start *
Personal Details*
Last name		Title
First name(s)		Over 16, over 18	Over 16 Over 18
Address	Home address Town / City County Postcode Country	Tel No: (please indicate preferred contact no.)	Home Work Mobile	Home Phone Number Work Phone Number Mobile Phone Number

Do you possess a valid driving licence *	Yes No	Do you require a work permit to work in the UK (if yes please bring evidence at interview) *	Yes No
Independent Safeguarding Authority (ISA) Pin Number

Employment Record - Present or most recent position
Employer		Position Held
Work Address	Work Address Town / City County Postcode Country	Dates Employed
		Salary
		Tel:
		Reason for leaving
Description of main duties

Previous Employment - Please give details of previous employment including any previous local authority employment for whom we may wish to obtain a reference.
Employer	Dates Employed	Post Held	Reason for Leaving
Employer 02	Dates Employed 02	Post Held 02	Reason for Leaving 02
Employer 03	Dates Employed 03	Post Held 03	Reason for Leaving 03
Employer 04	Dates Employed 04	Post Held 04	Reason for Leaving 04
Employer 05	Dates Employed 05	Post Held 05	Reason for Leaving 05

Education and Training (Secondary, further and higher education)
School / College	Dates Attended	Course / Subject	Result
School / College *	Dates Attended *	Course / Subject *	Result *
School / College 02	Dates Attended 02	Course / Subject 02	Result 02
School / College 03	Dates Attended 03	Course / Subject 03	Result 03

Vocational and work based training (including NVQ's)
Training Centre	Dates Attended	Course / Subject	Result
Training Centre	Dates Attended Training	Course / Subject Training	Result Training
Training Centre 02	Dates Attended Training 02	Course / Subject Training 02	Result Training 02
Training Centre 03	Dates Attended Training 03	Course / Subject Training 03	Result Training 03

Qualified nursing staff and General Social Care Council registered staff (if applicable)
Place of Study	UKCC PIN Number / GSCC Registration Number	Qualification	Expiry Date
Place of Study	UKCC PIN Number / GSCC Registration Number (8 char.)	Qualification	Expiry Date
Place of Study 02	UKCC PIN Number / GSCC Registration Number (8 char.) 02	Qualification 02	Expiry Date 02

Reasons for applying for this post.* Please refer to the job description and person specification supplied
Reasons for applying for this post

Please list all voluntary work / community activities / interests and hobbies
Please list all voluntary work / community activities / interests and hobbies

Are you related to anyone currently working for Guild Care or a Trustee?*		Are you related to anyone currently working for GuildCare or a Trustee Yes No
If Yes, please state where he/she works and position held

References* Please give details of 2 referees who may be contacted (not members of your family). One referee must be your current or most recent employer and the other must be any local authority employer if applicable
Name		Name
Address		Address
Relationship		Relationship
Tel. No.		Tel. No.
Fax / Email		Fax / Email

Recruitment Policy

It is Guild Care policy to employ the best qualified personnel for the job and provide equal opportunities for the development of all its employees, including promotion and training. It is our policy not to discriminate against any person because of their race, colour, national origin, sex, disability, age or marital status. The data collected in this application will only be used for the purpose of recruitment within Guild Care and will not be disclosed to any external agency. Both electronic and paper records of this application will be destroyed within 12 months of receipt unless an applicant is successful when they will form part of your personnel records. Please note due to the nature of Guild Care’s work this post is subject to disclosure and an appropriate Criminal Records Bureau check will be carried out.

Email Address *