Apply Here For Support Staff Roles

Application Form for Support Worker Roles

Name (with title eg Miss, Mr, Mrs)

Phone

Area preferred (Penzance, Redruth or Camborne)

No. of hours preferred

Home address

Date moved to this address

Address history in the last 5 years (with dates)

Any names changes (with dates used)

NI Number

Nationality at Birth

Place of Birth

Education and Training

Full work history with dates (any gaps must be explained)

Knowledge, skills and experience relevant to the role

Notice period for current role

How did you get to know about the role

Do you require a work permit

Date available to start (eg 01/10/2020)

Do you have a valid clean driving licence

Do you own a car?

Are there any restrictions to your residence in the UK which might affect your right to take up employment in the UK?

Are you related to any current employees of Calton House Ltd?

Do you consider yourself to have a disability?

Are you able to work some weekends (essential for role)

Reference 1 - Most recent employer (name, email address, company, position and phone number)

Reference 2 - Previous employer (name, email address, company, position and phone number)

Further information section - please also list any restrictions you have on working hours or days

REHABILITATION OF OFFENDERS ACT 1974 – NOTICE TO OFFENDERS -Because of the nature of the work involved, the post for which you are applying is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Offenders Act (Exemption Order 1975). This means that you are not entitled to withhold information relating to any convictions you may have had. Do you have any convictions to disclose?

HEALTH SCREENING - The appointment of any post at Calton House Ltd is subject to satisfactory health screening. You will therefore be asked to complete a Declaration of Health and may be asked to undertake a medical examination if successful.

DBS CHECKS - Workers of Calton House Ltd are subject to the Care Act 2014 and are required to be subject to a Police Record Check through a Disclosure and Barring Service check. Please confirm if you are listed on the DBS Childrens or Adults Barred Register

I declare that to the best of my knowledge and belief the information given by me in this application is true, and I understand that the above information forms the basis of my contract of employment. I understand that if any of the information supplied by me is found to be falsely declared, my contract will have been fundamentally breached and my employment may be terminated immediately.

I understand that I cannot be offered a post until a satisfactory response has been received with respect to my DBS Register status, and that should I subsequently be offered a post, that offer will be subject to receipt of two satisfactory references, one of which must be from my previous employer, and that confirmation of the employment will be subject to a satisfactory criminal record check from the DBS.

By stating agree, I authorise the organisation to request a DBS Register check and a criminal records check from the DBS, on initial employment and at any time during my employment thereafter. I undertake to inform my employer immediately if my DBS Register status or criminal status changes at any time during my employment, such as by being charged with an offence, the administering of a warning, criminal conviction, referral to any register of barred care workers, or withdrawal of any registration required by my employment status.

I acknowledge that Calton House Ltd policy is to offer a voluntary basis initial ‘taster’ shadowing, to assess suitability for the role for both parties. This is for a maximum of 12 hours and payment will only be made for these hours, for applicants who proceed and join Calton House Ltd, and these hours will be included in their first contractual pay.

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