First Choice Home Care
Great British Care Awards Regional Finalist
Great British Care Awards Regional Finalist

Head Office & Snetterton 01953 667950

Halesworth 01986 800227
Norwich - Mental Health 01603 980394
Norwich - Domiciliary 01603 367729

Application Form

PRIVATE AND CONFIDENTIAL

Position

Applying for?
How did you hear about this vacancy?
Who advised you of this vacancy?

Personal Information

Name

Title
First Name
Last Name

Address

Address Line 1
Address Line 2
Address Line 3
Address Line 4
Postcode

Contact Details

Mobile Phone
Home Phone
Email

Education

School
Other
Training
Professional
Qualifications

Driving Licence & Travel Details (If Applicable)

Do you hold a Full UK Driving Licence?
Are you prepared to use your own vehicle for work?
Does your car insurance cover you for business?

Criminal Record & Work Permit

Please note any criminal convictions including those 'spent' under the Rehabilitation of Offenders Act 1974. If none, please state NONE.

Do you have a DBS certificate?
Date Issued
Cert Number

Work Permit/Info

Do you require a Work Permit/Pre-settled/Settled status to work in the UK?

please provide details below or provide share code to prove right to work in the UK.

Employment History

Name of employer
From
To
Job title & duties
Salary
Reson for leaving
Name of employer
From
To
Job title & duties
Salary
Reson for leaving
Name of employer
From
To
Job title & duties
Salary
Reson for leaving

Employment Gaps

From
To
Reason
From
To
Reason
From
To
Reason

References

Please note: All references will be checked in full, and referees may be contacted in person for clarification.

NO APPROACH WILL BE MADE TO YOUR PRESENT EMPLOYER BEFORE AN OFFER OF EMPLOYMENT IS MADE TO YOU AND WE HAVE YOUR CONSENT.

Current Employer

Company Name
Name
Position
Telephone
Address
Email

Previous Employer

Company Name
Name
Position
Telephone
Address
Email

Character Reference

Name
Profession
Telephone
Address
Email
How long known to you
In what capacity

Declaration

Please read this carefully before signing this application.

I confirm that the above information is complete and correct and that any untrue or misleading information will give my employer the right to terminate any employment contract offered.

Head Office

First Choice Home Care
1st Floor
2 Church Street
Harleston
Norfolk
IP20 9BB

01379 640100

Snetterton Branch

First Choice Home Care
1B Harling Road
Snetterton
Norfolk
NR16 2JU

01284 334986

Halesworth Branch

First Choice Home Care
25 Market Place
Halesworth
Suffolk
IP19 8AY

01986 800227

Norwich Branch

First Choice Home Care
First Floor
2 Barton Way
Norwich
Norfolk
NR1 1LG

01603 980394

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