EMPLOYMENT APPLICATION

Application Information

Your APPLICATION FOR EMPLOYMENT can be completed using the online application form below. Once complete, simply press the SUBMIT APPLICATION button to have your application sent through to us.

If you'd prefer to download the application form, you can click the DOWNLOAD FORM button at the bottom of this page. This can either be completed ‘on-screen’ and e-mailed back to us or it can be printed, filled in and then scanned and emailed back to us. Alternatively, the completed form can be sent to us via surface mail. Please post to the office you're applying to. Contact details can be found here.

For any queries, please call a member of our team.


APPLICATION FOR EMPLOYMENT

 

PERSONAL DETAILS


NEXT OF KIN CONTACT DETAILS


EMERGENCY CONTACT DETAILS


ABOUT THE POSITION / JOB PLACEMENT


LOCATION AND TRANSPORT


DATA PROTECTION ACT 1998 & INSPECTION

I hereby consent to information relating to me being processed by the Company (Primera Assisted Living Limited and its subsidiaries) in order that it may properly carry out its duties, rights and obligations. I understand that such processing will principally be for personnel, administrative and payroll purposes. I also understand that the term ‘processing’ included the obtaining, recording or holding of information or data carrying out any operation or set operations on the information data, including organising, altering, retrieving, consulting, using, disclosing, combining or destroying the information data. From time to time Primera Healthcare is audited by outside contracted clients and Agencies (i.e. NHS/ CQC/ HTE) that require your consent. I consent to outside clients and outside agencies having access to information held on my personal file for inspection, and for my information to be held on an in-house database.For the purpose of recruitment decisions some or all of the information contained in this application form may be shared with clients for the purpose of finding suitable assignments. I agree for the Company to check and verify my ISA registration on the ISA website and receive updates should any become available.


PROFESSIONAL QUALIFICATIONS & TRAINING COURSES


CURRENT EMPLOYMENT (A ten year full employment history is required. Please explain any gaps.)


PREVIOUS EMPLOYMENT (1)


PREVIOUS EMPLOYMENT (2)


PREVIOUS EMPLOYMENT (3)


MANDATORY TRAINING (all training must be completed within the past 12 months.

COURSE


TO BE COMPLETED BY ALL APPLICANTS



REFERENCES

All references must be a senior members of staff to you and 1 must be your current or last employer.

REFERENCE 1

May we approach this referee prior to interview




REFERENCE 2

May we approach this referee prior to interview


WORK ELIGIBILITY




DISABILITY


FURTHER INFORMATION

If there is anything else that you would like us to know about you, please enter it here.


WORKING TIME REGULATIONS

confirm that I may work more than an average of 48 hours a week. If I change my mind, I will give Primera Healthcare one month’s notice in writing to end this agreement.


REHABILITATION OF OFFENDERS ACT 1974

Primera Healthcare complies fully with the Disclosure and Barring Service (DBS) Code of Practice and we undertake to treat all applicants for positions fairly. You are encouraged to provide details of any criminal record you may have at an early stage. Please note that having a criminal record will NOT necessarily bar you from working with us. However, non-disclosure at this time may affect your application with us.

The Rehabilitation of Offenders Act 1974 (Exception Order 75) states that the Act does NOT apply to employment which is concerned with the provision of health services, or which is likely to enable the holder to have access to persons in receipt of such services in the course of their normal duties.

You must, therefore, provide details of any cautions, reprimands, warnings or convictions that you may have had, regardless of whether they are ‘spent’ or not.




PLEASE NOTE:

The cost of the DBS and the Independent Safeguarding Authority registration is to be met by you (the applicant).
If your DBS shows convictions either spent or unspent, Primera Healthcare will approach you to discuss this..


DECLARATION

The information that I have given in this registration form is, to the best of my knowledge, complete and accurate in all aspects. I understand that knowingly giving false information will disqualify me from registration with Primera Healthcare.

I also agree to keep Primera Healthcare advised of any changes to any of the information supplied. I am aware that where I have provided false information or provide false update information in the future Primera Healthcare reserves the right to report this to my professional body if appropriate.


CAPTCHA
Please wait...


Download Application Form


TOP