Application Form

Don’t worry, it’ll only take a few minutes!

Alternatively, if you wish to print out the form for yourself and send it in, click below. You can hand this in to any of our offices or email it to recruitment@srscaresolutionsscotland.com

Click here to download printable application form.

Please complete to the best of your ability. If you cannot complete any of the required fields, please input (N/A).

Do you have a legal right to work in the UK?

Are you a member of the PVG scheme?

If you are a member of the PVG scheme, enter your number.

Do you hold a full UK driving licence?

Do you have any points on your licence?

Are you registered with the SSSC?

Do you consider yourself to have a disability?

Have you had any disciplinary action taken against you in previous employment?

Do you have any live formal warnings / pending disciplinary action in another employment?

If you answered yes to any of the above questions, please provide details

Please let us know if you have completed the following training, and when you last did so.

Moving & Handling

Yes No

Adult Support & Protection

Yes No

Emergency First Aid

Yes No

Health & Safety

Yes No

Infection Control

Yes No

Dementia Awareness

Yes No

Medical Administration

Yes No

Catheter/Stoma Care

Yes No

Epilepsy Awareness

Yes No

Challenging Behaviour

Yes No

Palliative Care

Yes No

Enter your education history here.

Please list any recent employment history:

Would you like to add another job?

Yes No

Would you like to add another job?

Yes No

If there are any gaps in your employment history, please provide a reason for this:

Most Recent Employer Reference

If this isn't your most recent employer, tell us why

May we approach prior to interview?

Yes No

If you are unable to provide a recent employer reference, please state why:

Character Reference
Please not this can't be a friend or family member.

Name of character referee

Position of character referee

May we approach prior to interview?

Yes No

Additional Reference
Can be an employer or character reference.

May we approach prior to interview?

Yes No

Please write your supporting statement for your application here.

Rehabilitation of Offenders Act 1974
The provisions relating to the non-disclosure of criminal convictions do not apply to certain occupations. The position for which you are applying may be included in the excepted type of employment under the Rehabilitation of Offenders Act (Exceptions) 1974 order 1975. Please answer the following questions, read carefully and sign the declaration below.

Have you ever been convicted of any criminal offence(s) currently and/or do you have any criminal charge(s) pending?

Yes No

General Data Protection Regulation
SRS Care Solutions Scotland will use the information you provide in this application pack for the purpose of processing your application and monitoring the recruitment process. Should your application be successful, we may be required to share some of the information you provide with statutory bodies including the Care inspectorate and the Department of Work and Pensions. The information you provide in this pack will be stored securely and will not be retained longer than necessary. Unsuccessful applications will not normally be kept for longer than a year. You have a right to access the information that SRS Care Solutions holds on you. SRS Care Solutions has a written policy on the recruitment of ex-offenders, which is available to all applicants. Having a criminal record will not necessarily bar you from working, this will depend on the nature of the position together with the circumstances and background of any particular offences.

Declaration
I certify that all the information contained in this form and any attachments are true and correct to the best of my knowledge. I have not withheld any information which may affect my application for employment. I realise that false information or omissions may lead to dismissal. I agree to the information (which may include sensitive personal data) being used for legitimate purposes connected with recruitment and selection, including PVG Scheme membership. The information supplied above may be verified by SRS Care Solutions Solutions. I consent to the processing of data in accordance with the current GDPR legislation.

Signature (enter full name)

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