Job Application - Woodland Care Home

If you would prefer a printable format, please download a Word Document version of this form here.

Post Applied For:

How did you hear about the job?

About You

Surname*:

First Name*:

Address*:

Postcode*:

Date Of Birth*:

Home Tel*:

Work Tel:

Can we ring you at work?

Mob Tel:

Email Address*:

Are you related to anyone who works here now or in the past?

If yes, please give details:

About Your Education

Tell us about your education and the schools that you attended from the age of 13*

About Work*

Please describe any voluntary work that you have done:

References

Please provide us with the names of two people who can provide us with a reference as to your suitability for this post.

The first one should be your present (or most recent) employer. You should tell us if this is not the case. Neither of the references will be contacted prior to an offer of employment being made

Name*

Position*

Organisation*

Address*

Tel no*

Is this your current employer?

Are they related to you?

Name

Position

Organisation

Address

Tel no

Is this your current employer?

Are they related to you?

How is your health?

Regulation 21, Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 requires that all employees who work in care homes are both physically and mentally fit to undertake their duties.

Please answer the following questions:

How many days were you absent from work due to sickness in the last year?*

Have you ever suffered from: Allergies, eczema, dermatitis or other skin troubles?

Do you suffer from: Epilepsy, migraine, asthma, angina, heart trouble or any condition  requiring long-term medical help or an ongoing programme of medication

Have you ever suffered from: Mental illness including anxiety, stress, depression or nervous debility?

Have you ever required treatment for: Hernia or rupture, rheumatism, back problems, slipped disc, sciatica or Repetitive Strain Injury (RSI)?

Do you suffer from: Diabetes, ulcers, stomach or other intestinal disorders? 

Have you ever required treatment for: Hernia or rupture, rheumatism, back problems, slipped disc, sciatica or Repetitive Strain Injury (RSI)?

Tell Us More

Please use this space to tell us more about yourself and to add information that you feel is important in your application.

Tell us more about any additional skills you have, hobbies, interests and achievements. This section must be completed.

CV

Please upload your CV (either a PDF, or a word DOC)*

By submitting this form you:

certify that the information given in this application is true and accurate to the best of my knowledge. You also understand that if you are appointed and information is subsequently found to be false, you might be dismissed.
confirm that you know of no reason, in relation to your physical and /or mental health why you would not be able to undertake the duties required for the post applied for.

Opportunities at Woodland Care Home