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Application Form

You must complete all parts of this form. A copy of your CV is not required. Click on the arrows on the right to expand and collapse the form.

Personal Details

Title:

First names:

Surnames:

Home tel:

Mobile tel:

Email:

Address:
Postcode: Time at current address (Years)

Previous address
(if at current address less than 5 years) Postcode:

National Insurance Number

Driving Licence:

Are you a UK citizen?

Yes No

Clicking Continue on each section will save your progress in this browser only so you can return to your application at any time.

The job you are applying for

Position:

How did you hear about this vacancy?

Advert Job Centre Website Friend Other

Education and training

School attended:

From:

To:

Exams passed including subjects, grades and year:

College attended:

From:

To:

Exams passed including subjects, grades and year:

University attended:

From:

To:

Exams passed including subjects, grades and year:

Qualifications relevant to job applied for:

Memberships of professional bodies, PIN number and expiry date and certificates obtained:

Employment history

Full history must be provided

Current/most recent employer:

From:

To:

Address:

Position/responsibilities:

Salary/wage:

Notice period:

Reason for leaving:

Add employment history

About you

Why are you applying for this job?

What skills and special experience do you have that will help with this position?

What will our residents like about you?

References

Please provide names and addresses of 3 referees, one of whom should be your current or most recent employer and one other previous employer. The other should be a personal referee, someone who knows you well. Please do not give the name of a relative as a referee.

Current/most recent employer

Company name:

Referee name:

Referee position:

Address:

Postcode:

Tel:

Fax:

Email:

Please tick if you would prefer for us not to contact this referee unless an offer is confirmed

Previous Employer Reference

Company name:

Referee name:

Referee position:

Address:

Postcode:

Tel:

Fax:

Email:

Please tick if you would prefer for us not to contact this referee unless an offer is confirmed

Personal Reference

Company name:

Referee name:

Referee position:

Address:

Postcode:

Tel:

Fax:

Email:

Please tick if you would prefer for us not to contact this referee unless an offer is confirmed

If you were known to your referees by a former name please supply the name by which you were known:

Further information Declaration

I confirm that the information provided on this application form is true and complete, and that I am legally entitled to work in the UK.

I understand that any false statements or deliberate misrepresentations will be regarded as grounds for disciplinary action and/or termination of my employment.

I understand that any offer of employment is subject to satisfactory references and DBS Enhanced checks, and I authorise Athena Healthcare Group to obtain references to support this application once an offer has been made and accepted.

I understand that any information given in relation to my application will be held by the Company and falls within the provisions of the Data Protection Act 1998. I also give my consent for my personal information being retained and used to process my application for employment.

I agree to the above statements

Name:

Date:

You must complete all parts of this form before submitting your application

“Beautiful home in a lovely setting overlooking Coronation Park. The staff are excellent - my sister-in-law is very happy with everyone, and full of praise for the care she is receiving.”