APPLICATION FORM

EDUCATION AND QUALIFICATIONS 

EMPLOYMENT HISTORY Please list names of employers since leaving school, period of working with each employer and reason for leaving, starting with your most recent/current employer

REFERENCES

Please give names, addresses, and telephone numbers of two referees from your present/most recent place of work, one must be your manager. (MUST BE TWO EMPLOYMENT REFERENCES)

CRIMINAL RECORD CERTIFICATES 

If the position you are applying for (whether paid or voluntary) is listed is schedule 1, part 2 of the rehabilitation of offenders act order 1975, C & S Care Services is entitled to ask exempted questions as defined by section 113(5) of the police act 1997 about you. From July 2002 C & S Care Services is required by the domiciliary care agencies regulations 2001 to obtain a criminal record certificate in relation to any person who is a care manager or domiciliary care worker. This means that if your application is successful we will obtain from the criminal records bureau a criminal record certificate relating to you, before your appointment is confirmed. You are, however encouraged to tell us about any criminal record before we obtain a criminal record certificate.

Having a criminal record will not necessarily bar you from working with us. This will depend on the nature of the position and the circumstances and the background of your offences. C & S Care Services Ltd has a written policy on the recruitment of ex-offenders and we will give you a copy of it on request.

C & S Care Services Ltd observes the "Code of Practice for Disclosure and Barring Service Registered Persons" published by the Disclosure & Barring Service at DBS code of practice behalf of the home office, and we will give you a copy of it on request.

DECLARATION

I declare that I believe the information I have given on this application form is true.