General 1 — reflections-care.org

Email

Transport

Are you a car driver with access to use of a car?

Education

Please state most recent first. School/college/university & Qualification obtained (GCSE, NVQ, Degree etc)

Professional Qualifications

Awarding body/institution & Qualification obtained (CIPD, RGN, RMN, NVQ etc)

Experience

Current / Most Recent Employment

Reason for Leaving

Work Experience History

Previous Employer

Reason for Leaving

Work Experience History

Previous Employer

Reason for Leaving

Work Experience History

Previous Employer

Reason for Leaving

Work Experience History

Previous Employer

Reason for Leaving

Please give details if there are any gaps in your work history.

Email

Organisation & Position

Please add the dates (to and from) the individual has known you

Relationship to Applicant (eg. Line Manager, Supervisor etc)

May we take up this reference without contacting you beforehand?

Email

Organisation & Position

Please add the dates (to and from) the individual has known you

Relationship to Applicant (eg. Line Manager, Supervisor etc)

May we take up this reference without contacting you beforehand?

Are you related to, or do you have a close personal relationship with, any member of staff or directors of Reflections Community Support?

If YES, please state nature of relationship and give name.

Declaration

I declare that to the best of my knowledge the information given on this form is true and correct and can be treated as part of any subsequent contract of employment. I understand that, if appointed, any statement made on this form which is found to be false may result in my employment being terminated.

Equal Opportunities

Are you Male or Female?

Position applied for?

Employment Status (this section must be completed)

Are you a national of one of the European Economic Area countries who is able to work without a visa in the UK?

If NO, do you have a visa allowing you the unrestricted right to work in the UK?

Note: We will need to see originals of relevant documentation prior to appointment

Criminal Convictions (this section must be completed)

Do you have a current/pending conviction?

If YES, please give details

If the post is exempt from the Rehabilitation of Offenders Act 1974 you will be notified and required to complete a CRB check. If this has been indentified please declare if you have any spent convictions along with the details here:

Disability

Do you have a condition/impairment/disability* which may be relevant to your application?

Would you need any special support or facilities to enable you to take up this post?

If YES, please give details

Do you feel you may require additional help with our recruitment process?

If YES, a member of our team will then contact you to discuss your requirements.

* The Equalities Act 2010 defines disability 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’.

What is your ethnic origin?

(NB this is not a question about your nationality or place of birth)

Specify ethnic group

Sexuality

Sex and Gender Identity

Age Bracket

Please Specify

Declaration

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