Employee Application Form

Please read all instructions, job description and person specification prior to completing this form.

Post Applied For:

Preferred Region:

Where/how did you hear about the vacancy? If you were referred please state who.

Preferred Employment:

Personal Details


First Name(s):



Post Code:

Home Telephone Number:

Mobile Telephone Number:


National Insurance Number:

Are you entitled to work in the UK?

Do you need a Visa to work in the UK? (Provide details):

Are you registered with the SSSC?:

If yes, please provide your SSSC Registration number:

Are you a member of the PVG Scheme?

If yes, please provide PVG number:

Do any of your family members currently work for Care Visions?

Do you hold a current full driving licence?
(Please note for the post of Residential Child Care Worker a driving licence is a requirement):

Does your licence have penalty points or endorsements?

If yes, please give details:


Name of School Attended:

Date Attended:

Qualifications Gained At School (Subject, Grade):

Have you completed further education? YesNo

If yes, please provide details below:
(Name College/University, Any courses for which a certificate, e.g. SVQ, HNC, HND, degree or diploma was awarded. Name of Institute/College Qualification Subject Date Gained)

Are you currently in full or part time education? YesNo

If yes, please provide details below:
(Name College/University, Course Studying, Expected Date of Completion)

Membership of Professional Bodies

Are you currently a Membership of any Professional Bodies? YesNo

If yes, please provide details below:
(Name of Awarding Body/Institution, Class of Membership, Date of Re-registration)


Present or Most Recent Employment

Company Name:

Full Address & Contact Details:

Job Title:

Date Started:

Date Left (if applicable):

Salary & Other Benefits:

Notice period:

Main Duties & Responsibilities:

Reasons For Leaving:

References must be from a person who has line-managed/supervised you. We do not accept character references or references from friends. References may be requested prior to interview, please indicate if you would prefer that we did not contact a referee prior to an interview being held.


Job Title:

Relationship to You:


Phone Number:

May we contact this person now?


If no, please detail why:

Declaration IMPORTANT(Please read carefully before submitting)

Data Protection

In accordance with the General Data Protection Regulation & Data Protection Act of 1988, the information entered onto this form and any accompanying papers will be used to assess your suitability for the post and will not be released to anyone who does not require it for this purpose. If you are employed the information you have provided on this form will be used for personnel record and payroll purposes, otherwise the information will be destroyed six months after the post has been filled.

You have the right to require us to correct any inaccuracies in your information.

I certify that to the best of my knowledge all statements given by me on this form are true and accurate. I understand and accept that if it is subsequently discovered that any statement is false or misleading or that I have withheld information, my employment may be terminated without notice.

For more information on how we store and process your data, please read our Candidate Privacy Policy.