3 Education & Qualifications

Please list your relevant educational qualifications, starting with the most recent.

Qualification 1

Qualification/Certificate

Year Obtained

Awarding Body/Institution

Qualification 2

Qualification/Certificate

Year Obtained

Awarding Body/Institution

Additional Qualifications or Training

4 Employment History

Please provide details of your employment history, starting with your most recent position. Include all employment for the last 5 years.

Most Recent Employment

Employer Name

Job Title

Start Date

End Date (or 'Present')

Main Duties and Responsibilities

Reason for Leaving

Previous Employment

Employer Name

Job Title

Start Date

End Date

Main Duties and Responsibilities

Reason for Leaving

Explain any gaps in employment

6 Additional Information

Why do you want to work in care?

What skills and experience do you have that make you suitable for this role?

Do you have any health conditions or disabilities that might affect your ability to carry out the duties?

Yes

If yes, please provide details

Are there any conditions that would prevent you from undertaking the full requirements of this employment?

Yes

If yes, please provide details

Do you need any adaptations for your interview to accommodate any disability?

If appointed, when could you start? (Give period of notice if applicable)

Criminal Records Check: To ensure the safety of our clients, a DBS check must be completed for all positions. A criminal record will not necessarily be a bar to obtaining a position. This post is exempt from the Rehabilitation of Offenders Act 1974.

Criminal Convictions

7 References

Please provide details of two professional references. We will only contact referees once you have been interviewed and provisionally offered the post.

Reference 1

Name and Relationship to You

Address

Telephone

Reference 2

Name and Relationship to You

Address

Telephone

8 Declaration

Please read carefully before submitting:

I agree that Seraphic Chambers Care Agency Ltd can create and maintain computer and paper records of my personal data and that this will be processed and stored in accordance with the Data Protection Act 2018 and UK GDPR.

I confirm that all the information given by me on this form is correct and accurate and I understand that if any of the information I have provided is later found to be false or misleading, any offer of employment may be withdrawn or employment terminated.

I agree to the above declaration

Full Name (as signature)

Date

Thank you! Your application has been submitted successfully. We will review your application and be in touch soon.

There was an error submitting your application. Please try again or contact us directly.

Support Worker Application Form

1 Personal Information

2 Position Details