Join Three Sisters Care in Redbridge

APPLICATION FORM

Welcome to the Three Sisters Care job application page! We’re excited that you’re considering joining our compassionate team. If you’re passionate about providing quality domiciliary care, please complete the application form below. We look forward to connecting with you soon!

Alternatively you can contact us on:

020 7790 6057
manager@threesisterscare.co.uk

APPLICATION FORM THREE SISTERS CARE

Please ensure that you complete the application through to page 8 otherwise your application will not be saved and you will have to start again.

Page 1 of 8

How did you hear about us? *

Website

Total Jobs

Care Friends App

Friend/Relative

Social Media

Other

Please specify other*

Position Applied for ?*

Support Worker

Senior Support Worker

Please click NEXT to continue with the application form.

PART 1: APPLICANT BASIC DETAILS

Name of applicant*

Prefix

First name

Last name

Date of Birth*

Nationality*

Contact number mobile *

Email address*

NI Number

Current address*

Postal code*

PART 2: NEXT OF KIN / EMERGENCY DETAILS

Name of emergency contact*

Prefix

First name of emergency contact

Last name of emergency contact

Emergency contact number*

Relationship of emergency contact*

Home address of emergency contact

PART 3: GENERAL INFORMATION, WORK ELIGIBILITY AND BACKGROUND CHECKS

What is your preferred geographical location to work in? Please select:*

Redbridge

Tower Hamlets

Essex

Other

Please specify other preferred geographical location*

How will you travel to work?*

Public transport

Car

Electric Scooter / Motor bike

Bicycle

Walk

AVAILABILITY

Domiciliary Care requires people to be available to work at various times including nights and weekends. You will be required to work in at least one or more of these bandings.

Please select your preference.

I am available to work:*

Full time

Part time

Weekends only

Please select the bandings of your preference*

7am -11am

12pm-2pm

4pm – 8pm

8pm-11pm

Please indicate if you are restricted in the number of hours you can work each week?

Maximum number of hours you can work in a week:*

Please explain why you can only work the hours listed above*

MORE INFORMATION ABOUT YOU

Please select applicable status*

Please specify what visa you are on, the expiry date and any restrictions on the number of hours you are permitted to work.

Type of visa (Student, Work visa etc)*

Restrictions on my visa *

Expiry date of visa (dd/mm/yyyy)

LANGUAGES

Please tell us about the languages you can speak and/or write and how you rate your ability with these languages: (As part of your application you will be required to complete an English Proficiency Test)

I can speak English*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

Please list language

I can speak this language*

Good

Average

Very basic

Add another language

CRIMINAL RECORD CHECKS

Care workers work with very vulnerable people and it is our responsibility to ensure that we carry our vigorous checks on the suitability of people we employ to work in this sector. Your appointment will therefore depend on the satisfactory completion of a criminal records disclosure. The Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 states that the Act does NOT apply to people working in health and social care and you must therefore please provide details of any convictions, cautions, reprimands, or warnings you have had regardless of whether they are spent or not. We therefore ask that you please answer the following questions truthfully:

1. Have you ever been cautioned, reprimanded, warned or received a criminal conviction?*

Yes

2. Are you currently under investigation for a criminal act?*

Yes

Please provide full details below:

3. Do you consent to Three Sisters Care carrying out a DBS check on you?*

Yes

Thank you for your interest in Three Sisters Care. Unfortunately DBS checks are a legal requirement for the type of work we do and we therefore cannot process your application.

Information for DBS (police check)

Your title

Name*

First

Last

Your gender*

Your NI number

Current address*

Date I moved to this address

Date I left this address

Previous address*

Please give previous address even if its from outside of the UK

Date I moved to this address

Date I left this address

If this is less than 5 years, please list your previous addresses going back 5 years

Have you ever been known by any other first name or surname?

Yes

If yes, which name?

Between which dates did you use that name?

Which town were you born in? *

Which country were you born in? *

What was your nationality at birth? *

Have you changed your nationality since birth? *

What is your current nationality? *

PART 4: WORK HISTORY / EDUCATION

We are required by law to make sure we know about the work you have done in the past, as well as the periods you may have spent out of employment. Therefore, please list your full employment history here, including any periods when you were not working (along with an explanation of what you were doing).

Have you worked or studied before?*

Yes

Why have you never worked or studied and what have you been doing?*

Housewife

Unemployed

Raising children

Travelling

Other

Please list other reason for not working or studying

PRIOR WORK / STUDY 1

Name of company/employer or educational establishment*

Work/study period (from and to dates)*

Physical Address or website of company/employer or educational establishment*

Your job title or (if studying) your course title*

If prior work - What was the reason for you leaving this role? *

Contact person at company or educational establishment*

Phone number of contact person*

Email address of contact person*

Add additional work / study details

PRIOR WORK / STUDY 2

Name of company/employer or educational establishment*

Work/study period (from and to dates)*

If there are gaps between these and previous dates, please explain why

Physical Address or website of company/employer or educational establishment*

Your job title or (if studying) your course title*

If prior work - What was the reason for you leaving this role? *

Contact person at company or educational establishment*

Phone number of contact person*

Email address of contact person*

Add additional work / study details

PRIOR WORK / STUDY 3

Name of company/employer or educational establishment*

Work/study period (from and to dates)*

If there are gaps between these and previous dates, please explain why

Physical Address or website of company/employer or educational establishment*

Your job title or (if studying) your course title*

If prior work - What was the reason for you leaving this role? *

Contact person at company or educational establishment*

Phone number of contact person*

Email address of contact person*

Add additional work / study details

PRIOR WORK / STUDY 4

Name of company/employer or educational establishment*

Work/study period (from and to dates)*

If there are gaps between these and previous dates, please explain why

Physical Address or website of company/employer or educational establishment*

Your job title or (if studying) your course title*

If prior work - What was the reason for you leaving this role? *

Contact person at company or educational establishment*

Phone number*

Email address of contact person*

Add additional work / study details

PRIOR WORK / STUDY 5

Name of company/employer or educational establishment*

Work/study period (from and to dates)*

If there are gaps between these and previous dates, please explain why

Physical Address or website of company/employer or educational establishment*

Your job title or (if studying) your course title*

If prior work - What was the reason for you leaving this role? *

Contact person at company or educational establishment*

Phone number of contact person*

Email address of contact person*

REFERENCES

Please provide referee contact details below that must match the work or educational history you have provided above: The first of these people must be your current or most recent employer. The other referees will ideally also be your most recent previous employers. If you cannot provide the details of your previous employers, you may substitute one or more of these with a referee who was a former tutor or teacher when you were in formal education. If you cannot provide details of a teacher or tutor, we may accept a personal reference from a person of professional standing (e.g. a doctor, lawyer, accountant, recognised religious leader or teacher) who knows you, either professionally or personally.

We cannot accept the names of friends or relatives or colleagues that are/were not senior to you as referees.

If references do not return after two weeks of requesting. Then your application will be rejected.

All references will be verified.

Please select one of the following reference options*

PROFESSIONAL REFERENCES

2 x Professional References will be required.

REFEREE 1

Full name*

Position in company*

Your role *

Company or educational establishment*

Address & postcode *

Email address*

Phone number*

Employment or study period (from and to dates)*

REFEREE 2

Full name*

Position in company*

Your role *

Company or educational establishment*

Address & postcode *

Email address*

Phone number*

Employment or study period (from and to dates)*

CHARACTER REFERENCES

3 x Character References will be required and can only be considered if you are unable to provide 2 x professional or further educational references with a valid reason.

Why are you supplying character references rather than professional or educational references?*

CHARACTER REFEREE : 1

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

CHARACTER REFEREE : 2

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

CHARACTER REFEREE : 3

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

CHARACTER REFERENCES

If you have no prior work or educational history, we may accept a personal character reference from a person of professional standing (e.g. a doctor, lawyer, accountant, recognised religious leader or teacher) who knows you, either professionally or personally.

We cannot accept the names of friends or relatives that are/were not senior to you as referees.

All references will be verified.

CHARACTER REFEREE 1

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

CHARACTER REFEREE 2

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

CHARACTER REFEREE 3

Name of character reference*

Profession of character reference*

Address & postal code of character reference*

Email address of character reference*

Phone number of character reference*

How does your character reference know you?*

PART 5: TRAINING

Have you attended any training courses specific to Health and Social Care?*

Yes

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Add additional courses

Course attended/completed

Date of course

Can you provide training certificates to evidence any of the above training?*

Yes

EQUAL OPPORTUNITIES MONITORING

Three Sisters Care is an employer committed to Equal Opportunities. We wish to ensure the fair and unbiased treatment of all job applicants. Please answer the below questions to enable us to monitor the effectiveness of our equal opportunities policy.

HEALTH QUESTIONNAIRE

Do you have any medical conditions that we should be aware of that might affect your fitness to work? *

Yes

Prefer Not to Say

Please provide details below*

How would you describe your ethnic origin?

Please specify other ethnic group

Please indicate your religion

Please specify other religion

Please indicate your gender

Please specify other gender

Please indicate your sexual orientation

Please specify other sexual orientation

Please indicate your age group

Do you consider yourself to have a disability?

PART 6: DECLARATION

I, the job applicant named on the front of this form, confirm that the information I have given in this application is accurate and true to the best of my knowledge. I also understand and agree that:

1. The company may make checks to verify the information I have provided;
2. Providing misleading or false information in this form or at any other time during the application process may disqualify me from appointment or, if I have already been appointed, may result in my dismissal;
3. The personal information I have provided in this form (and any other personal information that I or my referees may provide) is confidential and will be handled in line with the Data Protection Act 1998;
4. The company will use the personal information I have provided to decide if I am suitable for the job I have applied for;
5. Until I am employed, the company will not use my personal information for any purpose other than monitoring its own recruitment processes and that if the company does use my personal information for statistical analysis, it will be anonymised;
6. If my application is unsuccessful, the company will keep only my basic information and all other information supplied will be destroyed.
7. If my application is successful, my personal information will be used for legitimate purposes in relation to my work;
8. The company may process my personal information for the purposes described above or as otherwise permitted or required by law in line with its registration with the Information Commissioner;
9. Any offer of employment will depend on the receipt of satisfactory employment references and the satisfactory completion of a criminal records disclosure;
10. I will be liable for the cost of my initial criminal records disclosure;
11. I will be required to complete a pre-employment induction training programme prior to my starting work with the company;
12. My attendance on the induction training programme will not indicate any offer (on the part of the company) or acceptance (on my part) of employment and that the time I spend on the induction programme will therefore not count as working time for the purposes of calculating the company’s compliance with National Minimum Wage regulations; I will be liable for the cost of my induction training (£50). I understand that I will have the cost of this training reimbursed once I have completed three months service without interruption.
13. If my application is successful. I agree to treat as confidential all information about clients or former clients and their families that I learn during the performance of my duties as a support worker. And I understand that it would be a violation of policy to disclose such information to anyone without checking first with my manager.

I accept all the above terms and conditions.

Full name of applicant*

First

Last

Date signed by applicant (dd/mm/yyyy)*

Date of application submission

This field should be left blank