If you would like to apply for a care position at Blackpool homes, please print out the form below and fill in as much details as possible and post the completed form to our office. Alternatively you can download the application form by clicking the link here.

 

 

Position applied for:   

 

Personal details of Applicant 

 

 

Surname:

D.O.B:

Forenames:

Postal Address:

 

 

Email Address:

Telephone number:

 

Do you possess a valid current driving licence?       Yes     No    please circle

Details of any driving convictions during the past 5 years

1.

2.

                                                                                       None circle if applicable

 

Have you been convicted of any criminal offence?   Yes      No      please circle

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 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975.

Applicants are therefore not entitled to withhold information about convictions which for their purposes are ‘spent’ under the provisions of the Act, and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the company.

Any information given will be completely confidential and will be considered only in relation to an application to which the order applies.

Date

Offence details

 

 

 

 

Please continue on a separate sheet if necessary

 

Education, qualifications and training

 

School/University/College

From/To

Subject/s

Award/Grade

Secondary school

 

 

 

 

1

2

3

4

5

6

7

8

1

2

3

4

5

6

7

8

16+

 

 

 

16+

 

 

 

16+

 

 

 

16+

 

 

 

16+

 

 

 

 

Details of any special experiences (see accompanying information for ideas)

 

1. People based experiences

 

 

 

 

 

2. Family based experiences

 

 

 

 

 

 

  

3. Activity based experiences

 

 

 

 

 

 

 

 

 

4. Community based experiences

 

 

 

 

 

 

 

 

5. Other relevant experiences

 

 

 

 

 

 

 

 

Employment history

 

Please give your current/previous employers

  • name and address

  • the position you held

  • the date you started with them

  • the date you finished with them

  • the salary you received

  • your reason for leaving

 

Employers

Position

Start

End

£’s

Reason

Current/most recent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How much notice are you required to give your current employer?

………………………………………………………………………………………………………………………………………

It is Blackpool Homes Ltd’s policy to provide equal treatment of employees and job applicants in all areas of employment, regardless of race, colour, nationality, ethnic or national origins, sex, marital status, disability, age or religious beliefs.

 

Referees

 

(Please provide details of 3 people who may be contacted to provide references one of whom must be your current/last employer if employed in the last 2 years).

Unless otherwise indicated references will be pursued on receipt of this application. Please speak with your referee regarding this application.

Name

Address

Telephone and email

Position

Relationship to you

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Any other information to support your application

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I / we certify that the information provided is correct and has been completed by myself, the applicant.

 

Signed  _____________________________  Print name _____________________________  

 

Date _____________________________