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If you need access to this form in a different format e.g., large print or braille we are at present unfortunately unable to provide this.

Please use the job description and person specification to help structure your application. These documents outline the responsibilities for the job and the level of skill, knowledge, abilities, and experience required, where possible give examples to show how you match a particular skill.

All sections of the form must be fully completed.

It is important to include details of both work and voluntary/ non work periods with relevant information, from the time you left school to the present.

We will be happy to offer feedback in the event of you being unsuccessful at any stage of the recruitment and selection process. Please contact the recruitment manager or care co-ordinator for further information.

Information relating to age and work experience is requested to ensure that the company complies with the National Minimum Standards applicable to care providers.

Please give names and addresses of two referees who have given permission for their names to be used. You will need to give two employment references, one of which must be your current or most recent employer. Referees must be people who know you/have known you in paid or unpaid work or in an educational environment. Personal relations, friends, colleagues are not acceptable.

Criminal Convictions will be considered for recruitment purposes only when the convictions are relevant. For further information please contact the office.

The other information section can be used to make your case for the job. You should refer to the person specification and try to provide evidence of how you meet each requirement.

Do not forget to sign and date the form before you send it.

You are required to supply any other addresses if you haven’t lived at the current address for 5 years.

Please include academic, vocational, and professional qualifications and awards-most recent first.

Please note: It is a legal requirement to provide your academic/professional history from the age of 16. Where there are gaps in education or employment, you must give reasons.

Please include below additional training you have, a valid certificate of attendance for which you consider relevant to your application.
Please provide full details of your previous employment history. Dates given will be checked against your references and any other supporting documents. Where there are gaps in employment, please indicate why (e.g., childcare, family, continuing education, unemployment).
Please tell us about your experiences of caring for vulnerable adults and children. If you do not have any experience, please state ‘none’ in the comment box below
Please tell us about any other relevant skills / experience you have that may contribute to your role
Please provide referee details for current/most recent employer and at least another. Where applicable, please ensure that at least one of your references relate to a role where you have cared for vulnerable adults and children (either as an employee, or in a voluntary role).
Failure to supply referees will result in your application not being processed
Character reference
Anstey Healthcare is positive about disability and uses this information to help guarantee interviews to disabled applicants who meet the essential criteria.
Because of the nature of its work, Anstey Healthcare ltd, is covered by the Exemptions Order to the Rehabilitation of Offenders Act 1974, therefore unspent and spent convictions must be declared (including reprimands or warnings) that have been issued by a Court or Court-Martial in the United Kingdom or in any other country. (See Guidance notes for completing the application form).

Close Relatives

The nature of the role you are applying for requires that we undertake an enhanced DBS check, including Barred Lists. This check will be carried out prior to any formal offer of employment being made to you. Where a DBS check is returned marked, we will explore this with you before taking a decision on your suitability to undertake the role you have applied for. A marked DBS will not automatically bar you from employment with Anstey Healthcare Ltd Please confirm that you agree for this check to be undertaken*

Equal Opportunities

Anstey Healthcare Ltd is fully committed to the principle of Equal Opportunities in recruitment irrespective of colour, race, sex, marital status, sexual orientation, ethnic origin, nationality, religion, disability, or age.

Notice: Health

All applicants are reminded that it is unethical for Health Care Workers who know or believe themselves to be infected with any blood borne viruses (HIV, Hepatitis B or C) or other communicable diseases (e.g., Tuberculosis) to put patients at risk by failing to seek appropriate counselling or by failing to disclose it when notified. Such behaviour may affect your ability to practise within the health or social care industry.

Health Declaration

I certify that I know of any reason why my health would affect my ability to practice within the health or social care industry.

I understand that I will be required to obtain a “Fitness to Practice Certificate” via Anstey Healthcare’s occupational health provider.

I understand that no medical details will be disclosed without my permission to any individual other than those necessary and authorised within Anstey Healthcare Ltd.

I understand that failure to disclose information or the giving of false information may prohibit an offer of temporary staffing assignments.

Declaration

I declare that all the information I have given on this application form is true to the best of my knowledge and belief and not misleading or false. I understand that my application will be subject to a satisfactory DBS clearance and compliance with the Asylum and Immigration Act. I declare that by completing and submitting this application form, I hereby give express consent for Anstey Healthcare Ltd to process these details as appropriate for my application.