Published

16 October 2019

Location

Coventry, United Kingdom

Job Type

Full-time

Description

Please fill out this form to register with us.

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Title *

First name *

Surname *

Address *

Postcode *

Telephone no.

Mobile

Your e-mail address *

DOB *

National insurance number

Emergency tel

Next of kin and relationship

Address

Type of work you are looking for?

Where are you currently working?

Do you drive?

Do you have access to a car?

Qualifications

Please enter your qualifications into the fields below

Qualification 1

Title

Where obtained?

Date

Qualification 2

Title

Where obtained?

Date

Qualification 3

Title

Where obtained?

date

Qualification 4

Title

Where obtained?

Date

Qualification 5

Title

Where obtained?

Date

References

Referee 1

Contact name

Position

Address

Telephone no.

Referee 2

Contact name

Position

Address

Telephone no.

Referee 3

Contact name

Position

Address

Telephone no.

Referee 4

Contact name

Position

Address

Telephone no.

Referee 5

Contact name

Position

Address

Telephone no.

Employment details

Contact details of your last or current employer.

Name

Position

Address

Job title

Salary

(plus any benefits)

Date of starting

Reasons for leaving

Notice period

Job description

Previous employment

Employer 1

Employers name

From - to

Job title

Reason for leaving

Employer 2

Employers name

From - to

Job title

Reason for leaving

Employer 3

Employers name

From - to

Job title

Reason for leaving

Employer 4

Employers name

From - to

Job title

Reason for leaving

Employer 5

Employers name

From - to

Job title

Reason for leaving

Bank details

Bank name

Bank address

Account name

Account number

(8 digits)

Sort code

Ref number

Building society roll number

(max 20 digits)

Training

Please indicate which courses you have attended in the last 12 months.

Moving and handling

Date

Venue

Health and safety

Date

Venue

Adult / Newborn CPR

Date

Venue

Food and hygiene

Date

Venue

From time to time it may be required to disclose certain information regarding your application to place you into assignments. Please be assured only information that is absolutely necessary will be disclosed. We would appreciate it if you would amend the statement below to declare your wishes. IF you have any concerns, please do Not hesitate to contact us.

By submitting your application to ACR Recruitment & Training Ltd you agree to this process and procedure prior to offer of employment.

I agree to have my information disclosed should it be required in the placement on assignments.
I Do not agree to have my information disclosed should it be required in the placement on assignments.

Medical fitness to work

Do you have any physical or health conditions that impact your capacity to work as required by Education Health Standards (England) 2003 Regulations?

Eligibility to work in the UK

Are you eligible to work in the UK?

Do you have any endorsements on your passport which may limit your stay or length of employment in the UK?

Do you require a work permit?

Rehabilitation of Offenders Act 1974

The Rehabilitation of Offenders Act 1974 (exception order 75) states that the Act does Not apply to any employment which is concerned in the provision of health services, or which is likely to enable the holder to have access to persons in receipt of such services in their duties.

Do you have any, or any pending convictions, cautions, reprimands or final warnings, which would not be filtered in line with current guidance?

ACR Recruitment & Training Ltd check, record & monitor the DBS status of all applicants where it is warranted or legislated. This will either take form of a brand new DBS check or utilisation of the DBS Update Service. Full details of the service can be found HERE. ACR Recruitment & Training Ltd will check at regular intervals to ensure this status is still valid.

I accept and understand the above statement.

Do you have a DBS Disclosure?

Disclosure number

Date of Disclosure

Working time directive

The current limit for working hours within the European Union is 48 hours per week. You are under No obligation to accept work offered to you and will never be instructed to work more than 48 hours per week, however you may choose to do so. Please confirm you have read and understood this information and indicate your desired choice below.

I have read and understood the statement above and...

I DO wish to work more than 48 hours per week.
I DO NOT wish to work more than 48 hours per week.

Work preference

Are you or have you ever registered with an employment agency before?

If so which agencies did you register with?

Agency 1

Agency name

From - to

Reasons for joining

Reasons for leaving

Agency 2

Agency name

From - to

Reasons for joining

Reasons for leaving

Agency 3

Agency name

From - to

Reasons for joining

Reasons for leaving

Agency 4

Agency name

From - to

Reasons for joining

Reasons for leaving

Agency 5

Agency name

From - to

Reasons for joining

Reasons for leaving

Availability for work

Are you looking for full or part time work?

How many hours per week are you available?

What type of work do you want to do?

Are you aware of our referral scheme?

Is there anywhere you would particularly like to work?

Is there anywhere you DO NOT want to work?

How far are you willing to travel?

Is there a different type of work you would like to try?

Curriculum Vitae

Browse for your CV and attach it to the application form

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Click browse then press upload to send us your CV

Equal Oportunities Policy

Data Protection Act 1998

I consent to ACR Recruitment & Training Ltd holding and processing data under the rules of the Data Protection Act 1998. I also acknowledge that my data may be forwarded to other persons for the purpose of conducting checks, references and audits. I acknowledge that without my consent to process my data in this manner ACR Recruitment & Training Ltd will be unable to search for suitable work for me.
I agree that ACR Recruitment & Training Ltd can contact me for marketing purposes concerning potential assignments or to inform me of any product or services that you think may be of interest to me. I understand that by restricting the way you can contact me may limit the information you provide and services you offer.

You may contact me by the following methods (please tick as appropriate):

Declaration

We may wish to contact you to ask for your opinion or view regarding our services. This may be via telephone, letter, email or other media as available.

Please tick here if you DO NOT wish us to contact you regarding this.

We may contact you to work with details of work, via telephone, letter, email or other media available.

Please tick here if you DO NOT wish us to contact you regarding this.

By sending this application, I declare the information in this application to be true & correct. I understand that if any of the data is untrue, misleading or I have failed to declare facts, future employment offers may be withheld or removed without Notice.

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