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Recruitment

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PERSONAL DETAILS

REFEREES

Please nominate two persons who are familiar with your work in a supervisory or managerial capacity, at least one of whom should be your present or most recent employer. References provided by friends or relatives will not be accepted.

Referee 1

Referee 2

References are usually sought for the successful candidate(s) only after the interview has taken place.

EDUCATION

Results in GCE/GCSE (or equivalent)
Subjects Passed Level Attained Grade Year Action

FURTHER EDUCATION

Degree / Diploma / Certificate Year Obtained Exams To Be Taken Action

PROFESSIONAL QUALIFICATIONS

Name of Professional Body Qualifications/Grade of Membership Date of Membership Current Member Yes / No Action

EMPLOYMENT HISTORY – PRESENT POST

PREVIOUS EMPLOYMENT

Please list your previous posts beginning with the most recent. Should there be gaps in your employment history through changing jobs or being unemployed please detail these also.
Name & Address of Employer Position Held Brief Outline of Main Duties Period of Employment Months/Years Reason for Leaving Action

ADDITIONAL INFORMATION

PERSONAL DECLARATION

Are you barred from working with vulnerable adults?

I declare that all the foregoing statements are true and complete to the best of my knowledge and belief.

I understand that any wilful misstatement or omission renders me liable to disqualification or, if appointed, to dismissal.

We reserve the right to verify the information you have provided and seek information from other sources.

CANVASSING WILL DISQUALIFY

Please ensure that you have completed all relevant parts of this application form including the equal opportunities monitoring section as only applications containing the information sought will be considered. The information in this application form will be held securely both manually and electronically on the BestSolutionsHealthcare (BSH) Ltd People & Development computer database in accordance with current Data Protection legislation. We will treat the information given in this application as confidential however applicants are advised that legal processes may require us to disclose the form to certain statutory bodies.

EQUAL OPPORTUNITIES MONITORING

BestSolutionsHealthcare (BSH) Ltd is committed to equality of opportunity for all job applicants regardless of sex, disability, marital status, caring responsibilities, religious affiliation, political opinion, sexual orientation, ethnic origin or age, and therefore selects staff solely based on merit.

Monitoring is undertaken in the interests of ensuring that BestSolutionsHealthcare (BSH) Ltd Equal Opportunities Policy is effective and you are requested to complete the following questionnaire by ticking appropriate boxes.

In accordance with the Disability Discrimination Act 1995, a disability is defined as:
“a person has a disability …. if he/she has a physical or mental impairment which has a substantial and long-term effect on his/her ability to carry out normal day-to-day activities.”

Access to this information will be strictly controlled and will not be available to those considering your application or employment. Monitoring will involve the use of statistical summaries of information in which the identities of individuals will not appear. The information will not be available for any other purposes other than equal opportunities monitoring and will have no effect on the outcome of your application.

If your application for employment is successful, the information will subsequently be transferred to the monitoring system operated by BestSolutionsHealthcare (BSH) Ltd. There it will be strictly controlled in accordance with an agreed Code of Practice.

NOTE: It is an offence under the Fair Employment (NI) Act 1989 to give false information to BestSolutionsHealthcare (BSH) Ltd for monitoring purposes.