International Recruitment

"*" indicates required fields

Step 1 of 5

The information you supply on this form will be treated in confidence.
If you obtained this position, would you continue in any other employment OR take on any other employment?*
Yes
No
Do we need to make any disability-related adjustments to allow you to take part in the recruitment process?*
Yes
No
Do you have any mental health or physical health support requirements to be considered if offered a job?*
Yes
No
SECTION 1 : Personal Details
Post Applied For:*

Title:*
Mr, Mrs, Miss, Ms, Other

Name*
First Last
Have you ever been known by any other names:*
Yes
No
If Yes, enter names

Home Telephone Number:
Mobile Telephone Number:*
Email*

Sex:*
Date of Birth:*

Day
Month
Year

Are you aged 18 years or over:*

Yes

No
Nationality:*
Country

Address*
Street Address City County / State / Region ZIP / Postal Code Country

Do you have a current full driving license:*

Yes

No
Copy of a valid passport:
Attach Evidence*
Max. file size: 5 MB.
Passport size picture of yourself for ID purposes:
Attach Evidence*
Max. file size: 5 MB.
Evidence of police clearance from country of residence and/or country of origin:
Attach Evidence*
Max. file size: 5 MB.
Evidence of passed IELTS/ English Test:
Attach Evidence*
Max. file size: 5 MB.
Proof of COVID vaccinations:
Attach Evidence
Max. file size: 5 MB.
Evidence of TB test result:
Attach Evidence*
Max. file size: 5 MB.

SECTION 2 : Rehabilitation of Offenders Act
Have you ever been convicted of a criminal offence?*

Yes

No
Have you any prosecutions pending?*

Yes

No
Details of Offence(s) and Sentence
(This information will be disclosed by the Criminal Records Bureau check which will be required if successful. Please note a criminal record will not necessarily be a bar to employment)
SECTION 3: Health
Number of days absent in the last 2 years:
Are you registered disabled?*

Yes

No
If yes please provide your disability number and details:
SECTION 4: Education
Education and Training*
Please list your qualifications in reverse order, starting with the most recent first. Also, include any training that you have received which did not lead to a qualification but which you feel is relevant to the post. If short-listed for an interview, please be prepared to bring original copies of any certificates relating to post-school qualifications or vocational qualifications.
Date Obtained:
Place of study & address:
Examinations taken & grades:

Other Qualifications:*
Please give details of any other qualifications obtained or relevant courses attended.
Date Obtained:
Place of study & address:
Examinations taken & grades:

SECTION 5: Employment Record
Please list chronologically, starting with current or last employer*
Name of Employer:
Employer Address:
Length of Employment:
Salary:

Date From:*
DD slash MM slash YYYY

Date To:*
DD slash MM slash YYYY

Main Duties and responsibilities:
If currently employed how much notice are you required to give?

(weeks)
Reason for leaving or seeking new employment:*
5: List of Employer (Employment History): Note: Please click on the + sign to add more employment history.
Please give summary details of all your previous employment (most recent first for a minimum of 10 years if Applicable). Please ensure you include all part-time and temporary positions held, even those that are not relevant to your application. Please ensure you include any periods of unemployment or any other time that is not accounted for.
Name of Employer:
Employer Address:
Length of Employment:
Reason for leaving:

SECTION 6: Reference
(1) Referee:*
Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your referees are.
Name of Referee:
Referee Job Title:
Email:
Telephone No:
Company Name:
Address:
May we contact your references prior to job offer:*
Referee 1:

Yes

No
(2) Referee*
The second referee can be your present employer or character reference (We will accept personal friends – No relatives.)
Name of Referee:
Referee Job Title:
Work Relationship:
Email:
Telephone No:
Organisation:
Address:
May we contact your reference prior to job offer:*
Referee 2:

Yes

No
SECTION 7: Emergency Contacts
Emergency Contacts/ Next of Kin:*
First Name :
Last Name:
Telephone Number:
Email:
Address:

SECTION 8: Personal Attributes
Please give details:
SECTION 9: Declaration
I confirm that the information provided in this application (and within my Curriculum Vitae if applicable) is both truthful and accurate. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place any subsequent employment in jeopardy. I understand that any employment entered into is subject to documentary evidence of my right to work in the UK and satisfactory references. I expressly consent to personal data contained within this form being recorded for the purposes of assessing suitability for the post and may form the basis of any subsequent personnel file.
Signed:*

Enter Fullname as signature proof.
Date:*
MM slash DD slash YYYY

Flourish Advanced Care Limited undertakes that it will treat any personal information that you provide to us, or that we obtain from you, in accordance with the requirements of the Data Protection Act 1998. After initial assessment, Flourish Advanced Care Limited may keep your details on file for opportunities that may arise in the future. Please tick if you do not wish us to hold your details.*
Yes
No
Upload CV:
Accepted file types: pdf, doc, docx, jpg, Max. file size: 5 MB.
Filetypes: pdf, doc, docx, jpg

SECTION 10: Recruitment Monitoring Form
This sheet will be separated from your application form upon receipt and does not form part of the selection process. It will be retained by Human Resources purely for monitoring purposes.
Application for the post of:
To help us ensure that our Equal Opportunities Policy is fully and fairly implemented please COMPLETE THIS SECTION OF THE APPLICATION FORM.
What is your Ethnic Group?
Choose ONE section from A to E, and then tick the appropriate box to indicate your cultural background.
A: White

White UK

Irish

White -non-UK

Any other white background
(please give details):
B: Black or Black British

Black Caribbean

Black African

Any other Black background
(please give details):
C: Mixed

White & Black Caribbean

White & Black African

White & Asian

Any other Mixed background
(please give details):
D: Chinese or other ethnic group

Chinese

Vietnamese

Any other ethnic background
(please give details):
E: Asian or Asian British

Indian

Pakistani

Bangladeshi

Any other Asian background
(please give details):
F: I do not wish to provide this information

Section Break
Gender:
Male
Female
Are you registered disabled?*

Yes

No
If yes please provide your disability number and details:
Age Group:*
16- 25
26 – 35
36 – 45
46 – 55
56 – 65
66 – 70
over 70
Media:

Please sate where you saw this advised.
Asylum and Immigration Act 1996:
It is now a requirement that before any offer of employment can be made, all candidates are to provide confirmation of their eligibility to work in the UK. Please bring one of the following original documents with you if invited to interview: a passport or an immigration and nationality directorate application registration card which evidence the right to work in the UK or a UK residence permit issued to an EEA national which confirms right of entry to or residence in the UK.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Dedicated to providing the highest level of domiciliary care to residential, nursing homes, and dementia care for older people in the comfort of their homes throughout the UK.

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CQC regulates Flourish Advanced Care Limited to provide care a Flourish Advanced Care Limited – Main Office
We haven’t inspected this service yet

We checked this service was likely to be safe, effective, caring, responsive and well-led during registration.

Get in touch

Address

39 Priestleys, Luton, England, LU1 5QL

Email

info@flourishadvancedcare.co.uk

Talk to us

+44158 2283172

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