Work Permits

(We are required to check work permit status for all potential employees)

Education History

Employment History

Employment History

Relevant Experience

Reference 1

(must be professional references one of whom must be your present or most recent employer) (Please note that we will only request a reference if you are offered an interview)

Reference 2

(must be professional references one of whom must be your present or most recent employer) (Please note that we will only request a reference if you are offered an interview)

Rehabilitation of Offenders Act 1974

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 Exemption Order 1975. Applicants are therefore, not entitled to withhold information about convictions which for other purposes are “spent” under the provisions of this Act, and in the event of employment, and failure to disclose such convictions could result in disciplinary action on behalf of DIAL4CARE RECRUITMENT SERVICES LTD

In accordance with Department of Health guidance on the protection of children, (DOH circular 88/9) all applicants appointed to the posts involving substantial access to children will automatically be subject to a police records check. Do you agree that such checks may be made concerning you if required? Yes/ No

Have you ever been convicted of a criminal offence, or been made subject to any Order, civil or criminal, made by a Court of Law, involving offences against the person, children, or the handling of money? Yes/No

If yes, please give details in a separate envelope and return it with your completed application form. Any information will be dealt with in a confidential manner and will only be considered in relation to an application for a position to which the order applies. Disclosure of information will not automatically exclude you from registration with DIAL4CARE RECRUITMENT SERVICES LTD

I certify that to the best of my knowledge the details provided by me on this form are correct, that I possess all the qualifications which I claim to hold and agree to abide by the terms and conditions of engagement.