Domiciliary Care Team Leader (Roving Nights) - Grimsby

Salary	Hours	Location
£12.82 per hour	24 hours per week	Grimsby

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Personal Information
Full Name*
Telephone*
Email*
1. Personal Information
Title*
Name*
First Last
Are you over 18?*
- Yes
Address*
Street Address Postal Code
Telephone*
Email*

2. Current / Most recent employer
Company Name
Nature of Business
Position Held
Salary
Date From

Day
Month
Year
Date To

Day
Month
Year
Brief explanation of duties
Reason for leaving

3. Previous employers
Please give company names, positions, dates and reason for leaving previous employers

4. Training / Qualifications
Please give qualifications, grades and dates passed
Do you have a full, valid UK drivers license?*
- Yes
- No

5. Relatives
Are you related to anyone working for this organisation? if so please give details including name and place of work:*

6. Rehabilitation of offenders act 1974
The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020) provides that when applying for certain jobs and activities, certain convictions and cautions are considered ‘protected’. This means that they do not need to be disclosed to employers, and if they are disclosed, employers cannot take them into account. Guidance about whether a conviction or caution should be disclosed can be found on the Ministry of Justice website.
Do you have any unspent conditional cautions or convictions under the Rehabilitation of Offenders Act 1974?*
- Yes
- No
If so, please give details, including date and place of the conviction:
Do you have any adult cautions (simple or conditional) or spent convictions that are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020?*
- Yes
- No
If so, please give details, including date and place of the conviction:

7. Disability
In order to enable us to help annyone who has a disability to proceed their application and to subsequently fulfil the duties of the position, we need to know of any reasonable adjustments which may be necessary to help him/her attend an interview or undertake the duties of the position. If you have (or think you may have) a disability, please give details below:
This information will not be used to discriminate against disabled applicants

8. Working Eligibility
Are you eligible to work in the UK?*
- Yes
- No
Do you have a valid work permit (if applicable)?
- Yes
- No

9. References
Name*
First Last
Job Title
Address*
Street Address Postal Code
Relationship
Telephone*
Please select if you do not want us to contact before interview
Name*
First Last
Job Title
Address*
Street Address Postal Code
Relationship
Telephone*
Please select if you do not want us to contact before interview

10. Declaration
I give permission to the HICA Group to obtain references to support my application and to share appendix 1 with referees if needed. I understand that any job offer depends on a satisfactory DBS disclosure and may include a DBS Adult First Check and/or a Digital Verification check. By completing your DBS application, you are giving us consent to deduct the cost, which should not be more than £65. If this causes financial difficulties, we can consider other options. I understand that any job offer also depends on receiving 2 satisfactory references and proof of my right to work in this country. I confirm that the information on this form is true and complete to the best of my knowledge. Any false statement may lead to rejection or dismissal if employed. I also give permission to the HICA Group to keep and use the information on this form and any future information related to my application or employment, in line with the Data Protection Act 1998.*
I give permission to the HICA Group to obtain references to support my application and to share appendix 1 with referees if needed. I understand that any job offer depends on a satisfactory DBS disclosure and may include a DBS Adult First Check and/or a Digital Verification check. By completing your DBS application, you are giving us consent to deduct the cost, which should not be more than £65. If this causes financial difficulties, we can consider other options. I understand that any job offer also depends on receiving 2 satisfactory references and proof of my right to work in this country.

I confirm that the information on this form is true and complete to the best of my knowledge. Any false statement may lead to rejection or dismissal if employed. I also give permission to the HICA Group to keep and use the information on this form and any future information related to my application or employment, in line with the Data Protection Act 1998.
I agree to above declaration

Older People

Learning Disabilities

Residential Care

Homecare

Learning Disibilities

Other

Document Library

Older People

Learning Disabilities

Residential Care

Homecare

Learning Disibilities

Other

Document Library

Salary

Hours

Location

Domiciliary Care Team Leader (Roving Nights) – Grimsby

Application Form

Step 1 of 10

Personal Information

1. Personal Information

2. Current / Most recent employer

3. Previous employers

4. Training / Qualifications

5. Relatives

6. Rehabilitation of offenders act 1974

7. Disability

8. Working Eligibility

9. References

10. Declaration