Home care in Newmarket, Bury St Edmunds and Haverhill


Application Form

  • General Information

  • including used to- from dates
  • Employment History

  • Please provide current/ most recent first. This must cover the whole of your working life. State reasons for any career breaks. Add as many fields as required.
  • Referees

    You must provide references from your two most recent employers. Please provide an additional character referee. All will be contacted, therefore please inform the referees of the fact you have used their name. if you are unable to provide the required references, please discuss the matter with us
  • Education

  • Please complete below, add more fields as required.
  • Training History/ Short Courses Attended

  • Please complete below, add more fields as required.
  • Carer Standards

    In order to guide the interview process, we would like you to indicate your personal philosophy of care by completing the following statements:
  • Capacity to Work in the UK

  • Criminal Records Disclosure

    Workers in this establishment are subject to the Care Act, and will be subject to a Disclosure and Barring Service Criminal Records Check. You will not be eligible for work in the care setting if you are on the ISA Register.
  • Health Details

  • (your GP will not be contacted without your permission). )

    Applicant’s declaration – read and understand as you will be required to sign official declaration at interview.

  • 1. I confirm that the information I have supplied is complete and correct, and I understand that any incomplete, untrue or misleading information given to the employer will entitle the employer to reject my application, withdraw any employment offer made, or, if I am employed, dismiss me without notice.

    2. I understand that if any of the information supplied by me is found to be falsely declared my contract may be fundamentally breached and my employment may be terminated immediately.

    3. I understand that I cannot be offered a post until a satisfactory response has been received with respect to my ISA Register status, and I understand that should I subsequently be offered a post, that offer will be subject to receipt of two satisfactory references, one of which must be from my previous employer, and that confirmation of the employment will be will be subject to a satisfactory criminal records check from the DBS. I understand that until a satisfactory response is received from the DBS I will be supervised at all times at work and will not seek to have unsupervised access to vulnerable people.

    4. By signature on this application I authorise the organisation to request and ISA Register check and a criminal records check from the DBS on initial employment and at any time during my employment thereafter. I undertake to inform my employer immediately if my ISA Register status criminal status changes at any time during my employment, such as being charged with an offence (other than motoring offences), the administering of a warning, criminal conviction, referral to any register of barred care workers, or withdrawal of any registration required by my employment status.

    5. By my signature, I give authority to the employer to contact my GP for further details regarding any of the potential health problems I have declared above.

    6. I agree that the employer reserves the right to require me to undergo a medical examination to assess my suitability for night work.

  • Equal Opportunities Monitoring Form

  • This form will be detached and filed separately from your application.

    This reply is anonymous and confidential.

    The organisation is committed to promoting equal opportunities for all its employees and all prospective employees.

    To ensure that all applicants are dealt with equally, we wish to monitor your recruitment process and would ask for your help by completing the details below by placing a ‘tick’ in the appropriate box. This will allow our organisation to monitor its policies.

    Please note: you do not have to complete this form. The information is given on a voluntary basis and the information will only be used for monitoring purpose. Please do not enter any identifying marks on this form, so that your information remains confidential. This information will be stored on a computer.