Job Application

Quayside Care Ltd Application Form

Work Preferences

Personal Details

Are you a Driver?
Own Vehicle


Please provide the following details:

  • School / College / University
  • Date from / to
  • Examinations / Qualifications


Training Courses

Please provide the following details:

  • Subject
  • Location
  • Date
  • Details


Professional Membership / Registrations

Please provide the following details:

  • Name of Organisation
  • Registration Number
  • Renewal Date
  • Details


Employment History

Please record below the details of your full employment history beginning with your current or most recent first. Any gaps must be explained.

Please provide the following details:

  • Start / End date
  • Job Role
  • Duties
  • Employer Name
  • Contact Name
  • Address
  • Tel & Email
  • Reason for Leaving



References: Please provide names, addresses and telephone numbers for referees below who we may approach for a reference.

You must provide references from your two most recent employers. In line with CIW requirements, we require referencescovering your last five years employment. If you have not had more than one employer in the last five years, we require a further reference. Please provide two character references if you are unable to obtain two professional references, e.g., in the case of an applicant who has been raising children for ten years. All will be contacted, therefore please inform the referees ofthe fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.

Please provide the following details:

  • Contact Name
  • Business Name
  • Address & Post Code
  • Tel & Email
  • Capacity in Which Known


Safeguarding/Ex Offenders Declaration

The Rehabilitation of Offenders Act 1974 aims to promote equality of opportunity and is committed to treating all applicants regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. undertakes not to discriminate unfairly against applicants based on a criminal conviction or other information declared. Answering 'yes' to the question below will not necessarily prevent your employment.This will depend on the relevance of the information you provide in respect of the nature of the position and the circumstances.
Are you currently bound over, or do you have any current UNSPENT convictions that have been issued by a Court or Court-Martial in the United Kingdom or in any other country?
Do you have any current UNSPENT police cautions, reprimands, or final warnings in the United Kingdom or in any other country?


Privacy Statement

We will only collect data for specified explicit and legitimate use in relation to the recrpuitment process. By signing this application form, you consent to holding the information contained within this application form. If successfully shortlisted, datawill also include shortlisting scoring and interview records. We would like to keep this data until the vacancy is filled. (Wecannot estimate the exact time, but we will consider this period over when a candidate accepts our job offer for the position forwhich we are considering you). When that period is over, we will either delete your data or inform you that we would like to keepit in our database for future roles.

We have privacy policies that you can request for further information. Please be assured that your data will be securely stored by the Registered Manager and only used for the purposes of recruiting for this vacant post.

You have a right for your data to be forgotten, to rectify or access data, to restrict processing, to withdraw consent and to be keptinformed about the processing of your data. If you would like to discuss this further or withdraw your consent at any time, please contact the Registered Manager to discuss



The information in this application form is true and complete. I agree that any deliberate omission, falsification, or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed. Where applicable, I consent that can seek clarification regarding professional registration details.


Supporting Statement

Please add here your reasons for applying. You should refer to the job description and person specification to guide you. It would also be of value to describe strengths and talents that set you apart from others as well as including skills gained from work, home, and other activities.