International Recruitment Post applied forSenior Care WorkerCare AssistantFull name *GenderMaleFemalePrefer not to sayOtherHome Address *Are you applying from UK?YesNoDaytime Contact Number *Email Address *National Identity Number *Day Contact Number *Date of Birth *DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924Present Nationality *Do you have a current driving licence?..........YesNoCurrent EmploymentName of your most recent/last employer *Address of employer *Nature of business *Position Held *Reasons for leaving *Employment HistoryName and address of employer *Date *Position held and main duties *Reasons for leaving *Name and address of employer *Date *Position held and main duties *Reasons for leaving *Qualifications and TrainingName of Institution *Course *Qualification *Date completed *Name of Institution *Course *Qualification *Date completed *Please give details of relevant experience. This may be taken from the work situation, voluntary work and placement/attachment *Assistance with interview questionsDo you require us to make any special arrangements in order for you to participate in the recruitment process? For example, large print forms? Or additional time to complete forms? *Please select an optionYesNoIf yes, please give detailsEmployment ReferencesPlease provide 2n professional referees detailsReferee Name *Position *Company Name *Telephone number *Email Address *Full company address *Referee Name *Position *Company Name *Telephone number *Email Address *Full company address *Character ReferenceFull name *Address *Relationship to you *Phone Number *Requirements ChecklistKindly take note of the statement below; To ensure that you qualify for the Health and Social Care Visa please refer to the eligibility criteria below. Do not make any contact if you do not meet any of the requirements.Where did you complete your placement/attachment? *Duration of attachment? *Upload Red Cross Nurse Aid training Level 3 here *Drag and Drop (or) Choose FilesUpload IELTS General UKVI Level B1 with minimum score 5.0 or a Degree validated by ECCTIS UK here *Drag and Drop (or) Choose FilesUpload TB Test in an approved Home Office test centre - Diagnostic Imaging (Not more than 3 months) here *Drag and Drop (or) Choose FilesUpload Passport here *Drag and Drop (or) Choose FilesUpload Police Clearance (Not more than 3 months old) here *Drag and Drop (or) Choose FilesUpload Degree hereDrag and Drop (or) Choose FilesUpload General Secondary Certificate here *Drag and Drop (or) Choose FilesUpload Drivers License here *Drag and Drop (or) Choose FilesDo you currently have access to a car? *Please select an optionYesNoDeclaration of CriminalREHABILITATION OF OFFENDERS ACT 1974 (EXCEPTIONS AND EXLUSIONS (SCOTLAND) ORDER 2003. You are not entitled to withhold information about convictions which for other purposes are spent under the provisions of the Act and in the event of employment any failure to disclose such convictions could result in dismissal.Have you ever been convicted of a criminal offence or cautioned, or are you at present subject of criminal charges or proceedings? *Please select an optionYesNoIf you have answered yes please give details:Nature of OffenceDate of ConvictionPenalty/SentenceSignature And DeclarationI 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 may have been fundamentally breached, and my employment will be terminated immediately. I understand that I may not be offered a post until satisfactory response has been received with respect to my PVG register status, and that should I subsequently be offered a post, that offer will be subject to receipt of two satisfactory references. By my signature, I authorise Baal-Perazim Care Services to request PVG background check. I undertake to inform my employer immediately of any change to my PVG, such as being charged with an offence, referral to any register of barred list, or withdrawal of any registration required by my employment status.Full name *Signature *Date *Consent *Yes, I agree with the privacy policy and Service User Privacy Statement. Send Message