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Select Preferred PositionRegistered NurseHealthcare AssistantSenior CarerSupport WorkerDomestic Duties
Mr.Mrs.Miss.Dr.Prof.Rev.
Do you have a passport?YesNo Which passport do you hold ?British PassportEU PassportNon-European/British Passport Upload passport data page here Accepted file types: jpeg, png, pdf, Max file size: 5mb Upload Working Permit/Biometric Front Page Accepted file types: jpeg, png, pdf, Max file size: 5mb Upload Working Permit/Biometric Back Accepted file types: jpeg, png, pdf, Max file size: 5mb Do you have a full driving license? YesNo Upload your full driving license here Accepted file types: jpeg, png, pdf, Max file size: 5mb Do you have your own vehicle for work ? YesNo
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Are you on A COS? * YesNo Do you have a DBS Certificate? * YesNo Do you have a Care Certificate? * YesNo Upload your CV Accepted files: jpg, gif, pdf, png Upload Your Care Certificate Accepted files: jpg, gif, pdf, png Upload Your DBS Certificate Accepted files: jpg, gif, pdf, png Education Examinations/Qualifications Date Obtained Further Education Examinations/Qualifications Courses Taken Date Obtained Further Qualifications & Training
Please give a job description of your present/last job and your responsibilities Company Name Address Start Date End Date Job Title Reason For Leaving Type Of Business Salary
Supporting Information Describe the particular skills and abilities you possess which illustrate your suitability for this post giving examples where appropriate. State briefly why you are interested in this post and how you see yourself fulfilling this role.
The following information may be required if the post you are applying for has a requirement for a DBS police check
Are you aware of any police enquires undertaken following allegations made against you which may have a bearing for your suitability for this post ? YesNo
This act protects people with disabilities from unlawful discrimination. We actively encourage applications from people with disabilities. The Disability Discrimination Act defines a disability as a physical and mental impairment which has a substantial and adverse long term effect on their ability to carry out day to day activities Do you have a disability which is relevant to your application ? YesNo We will try to provide access equipment or other practical support to ensure that people with disabilities can compete with non-disabled people Do we need to make any specific arrangements in order for you to attend the interview ? YesNo
In line with educational health requirements, Kemhealthcare and consulting Ltd needs to ensure that all members are protected against or immune to certain diseases. Please provide details of current vaccination statuses (Proof will be required). Your health status is important to us. Please indicate below. Vaccination Select if applicable to you COVID-19 Recruitment Monitoring Form This sheet will be separated from your form upon receipt and does not form part of the selection process. It will be retained by Kemhealthcare simply for monitoring purposes Select Preferred PositionRegistered NurseHealthcare AssistantSenior CarerSupport WorkerDomestic Duties To help us ensure that our Equal Opportunities Policy is fully and fairly implemented( AND FOR NO OTHER REASON) please complete this section of the application form Black BritishBlack CarribeanBlack AfricanOther Black BackgroundWhite UkIrishWhite Non-UkOther White BackgroundWhite and Black CarribeanWhite and Black AfricanWhite and AsianOther Mixed BackgroundIndianPakistaniBangladeshiOther Asian BackgroundChineseViatnemeseOther Ethnic Background
DISCLOSURE AND BARRING SERVICE CHECK: A disclosure and barring service check will be requested in the event of you being offered the post. If you register with DBS Update Checking Service, your DBS will be checked as and when required
A security check will be performed in the event of you being offered the post
Because of the nature of the work you are applying for, this post exempted from the provision of section 4(2) of the rehabilitation of offenders Act 1974(Exception) order 1975. Applicants are therefore not entitled to withhold any information about convictions which for other purposes are “spent” under the provision of the Act and in the event of employment, any failure to disclose such conviction could result in dismissal from the company. Any information given will be completely confidential and will be considered only in relation to an application for the position to which the order applies.
Please select and upload all documents Passport Sized PhotographProof of Right to Work(if applicable)Tuberculosis Test CertificateProof of Address Upload your passport here Upload your Tuberculosis Certificate here Upload your proof of address 1 here Upload your proof of address 2 here Upload your Right To Work here
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