Job Application Form for Bay Tree House Care Home

Please complete this form to submit your application - note that your application will not be submitted until you click the “Submit” button at the end of this form. We look forward to reviewing your application.

All applications are dealt with in the strictest of confidence

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* 1. Which position are you applying for?

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* 2. Personal Information:

First Name/s

Last Name

Date of Birth

National Insurance Number

Address

Post Code

Mobile Number

Landline Number

Email address

Name and Contact Details of Next of Kin

Date of first Covid Vaccination or N/A if chosen not to have

Date of second Covid vaccination

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* 3. Are you authorised to work in the United Kingdom?

Yes

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* 4. Are you a member of a Trade Union?

Yes

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* 5. Are you related to someone currently working at Bay Tree House? If so, please disclose the name of your relative and the relationship to you

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* 6. If you have a portable DBS, please enter your certificate number

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* 7. Please give any details of the following (if applicable):
Rehabilitation of Offender's act 1974 (exemptions) order 1975
If you have any court convictions or police record of any description, you should include details of these within this application form. Please note that a criminal record will not necessarily be a bar to obtaining employment however, this post is one where you must disclose all convictions, pending prosecutions, cautions, reprimands and bind-overs

Convictions - including those that are considered spent;

Prosecutions pending
Spent or unspent convictions including police cautions
A history of being subject to an investigation, suspension or disciplinary procedure, DBS referral or Safeguarding
Dismissal from employment

If any of the above apply, please give details including dates, below

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* 8. Education and Qualifications

Name of Secondary School

Dates from and to

Name of College/University

Dates from and to

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* 9. Qualifications gained

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* 10. Have you completed or are working towards the following:

Principles & Values (Part one of the All Wales Induction Framework - Social Care Wales)

The full All Wales Induction Framework - Social Care Wales

The Care Certificate (England)

QCF Level 2 Health & Social Care

QCF Level 3 Health & Social Care

Other (please specify)

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* 11. If you are currently registered with Social Care Wales, please give your registration number and date of registration or N/A

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* 12. Employment History

Current or most recent employer

Address

Position Held

Dates to and from

Salary/Hourly Rate £

Reason for leaving/wanting to leave

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* 13. Responsibilities and Duties

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* 14. Skills

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* 15. Upload your CV that details your full employment history detailing any gaps in employment. It is important that you have this full information for registration with Social Care Wales

Click on the upload button and select your CV file to upload

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 16. You and your health - please select if you have any of the following that we need to be aware of for your safety at work

Angina, high or low blood pressure - heart disease

Diabetes; type 1 or type 2

Allergies; food, medications, creams, latex or other

Skin conditions such as eczema, dermatitis, psoriasis or other

Chest or breathing problems such as asthma, COPD, recurring chest infections, or other

Skeletal injuries or pain; back problems, limb problems, arthritis or other

Impairments to senses; sight, smell, touch, hearing, taste

Blackouts, epilepsy, or other

Stomach disorders, colitis, ulcers, Chron's disease, or other

Mental health conditions, depression, anxiety, addiction, or other

Any other conditions or disability

Other (please specify)

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* 17. Are you registered disabled?

Yes

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* 18. References - We require a reference from your current or most recent employer along with a second reference that can either be a character reference or another previous employer reference. A Character reference cannot be provided by a family member or friend - it must be a professional person.

Also, within the borough of Wrexham, we are required to request a reference from each employment you have held within health & social care so we will also apply for a reference for any previous employment in this sector.

Referee 1 - Current or last employer company name

Address

Name of Referee and position within the company

Contact Details: Telephone number and email address

Referee 2 - Previous employer company name

Address

Name of Referee and position within the company

Contact Details: Telephone number and email address

Character Reference name and occupation

Please state how you know this person

Address

Contact details: Telephone number and email address

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* 19. How did you hear about this position?

Company website

Job searching website - Indeed

Friend/family/colleague

College recruitment

Other (please specify)

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* 20. Please tell us about you and what skills and attributes you feel you can bring to the role you have applied for

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* 21. Declaration
I declare that the information I have provided is true and accurate

Signed - Please enter your name

Date

Job Application Form for Bay Tree House Care Home

Question Title

* 1. Which position are you applying for?

Question Title

* 2. Personal Information:

Question Title

* 3. Are you authorised to work in the United Kingdom?

Question Title

* 4. Are you a member of a Trade Union?

Question Title

* 5. Are you related to someone currently working at Bay Tree House? If so, please disclose the name of your relative and the relationship to you

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* 6. If you have a portable DBS, please enter your certificate number

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* 8. Education and Qualifications

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* 9. Qualifications gained

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* 10. Have you completed or are working towards the following:

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* 11. If you are currently registered with Social Care Wales, please give your registration number and date of registration or N/A

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* 12. Employment History

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* 13. Responsibilities and Duties

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* 14. Skills

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* 15. Upload your CV that details your full employment history detailing any gaps in employment. It is important that you have this full information for registration with Social Care Wales

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* 16. You and your health - please select if you have any of the following that we need to be aware of for your safety at work

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* 17. Are you registered disabled?

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* 19. How did you hear about this position?

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* 20. Please tell us about you and what skills and attributes you feel you can bring to the role you have applied for

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* 21. DeclarationI declare that the information I have provided is true and accurate

* 21. Declaration
I declare that the information I have provided is true and accurate