APPLICATION FORMS HCA ar Essay

Submitted By dakwadan
Words: 645
Pages: 3

TENDER-CARE SERVICES LIMITED

Care in the Community

For the standard of Care YOU deserve.

APPLICATION FORM
Please complete in black pen.
If you have any problems, please do not hesitate to contact us. The address and telephone number are as follows:

Angela Fraser (Director/Registered Manager)
Abby Russell (Director/Office Manager)
756 Wimborne Road
Moordown
BOURNEMOUTH
BH9 2DZ
Tel: 01202 533532

APPLICATION FOR POST OF: _________________________________________

PART 1: Applicant Details

Title: Mr Mrs Miss Ms Other _____

Surname: _______________________________

First Name(s): _______________________________

Address: _______________________________

_______________________________

_______________________________

Telephone: _______________________________

Date of Birth: _______________________________

National Insurance Number: _______________________________

Length of Notice required: _______________________________ weeks/months

Do you hold a full current driving licence and have use of a car? YES / NO

PART 2: References

Details of present or most recent employer. Previous Employer

Name: _______________________________ ______________________________

Job Title: _______________________________ ______________________________

Address: _______________________________ ______________________________ _______________________________ ______________________________

_______________________________ ______________________________

Telephone: _______________________________ ______________________________

Fax/email: _______________________________ ______________________________

Can we contact prior to interview YES / NO
PART 3: Education

Secondary schools and colleges attended, and any qualifications. Please state names and dates if possible.

______________________________________________________________________________

_____________________________________________________ Dates: __________________

______________________________________________________________________________

_____________________________________________________ Dates: __________________

Training if any which is relevant to the position applied for:

______________________________________________________________________________

_____________________________________________________ Dates: __________________

______________________________________________________________________________

_____________________________________________________ Dates: __________________

PART 4: Employment History

Dates to and from. Employer’s name
& address.
Job description and duties.
Salary
per hr/week
Reason for leaving.

PART 5: Health and Medical History

We are a caring employer. We have concern for your health and welfare. How many days sick have you had in the last year? _____ days/weeks. Have you any health issues you would like us to be aware of?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

PART 6: Confidentiality

Tender-Care Services Limited will treat all information it received regarding clients, customers and personnel with total confidentiality and to keep all records secure. The agency will never breach these rules of confidentiality. It is of the utmost importance that information received by this agency is not passed to outside sources.

You should be aware that any information disclosed, whilst in the employ of Tender-Care Services Limited