Trustline Job Application Form +44 03300 431223 info@trustlinecare.co.uk trustlinecare.co.uk Trustline Job Application Form Part 1 – Personal Details Application Form – Guidance Notes Please read the following instructions carefully before completing this form. Complete all sections of the application form in full. Incomplete applications may not be considered. Use black or blue ink if printing and writing by hand. You may type responses if submitting electronically. Where indicated, attach additional sheets if you require more space (ensure your name is on each one). Do not send CVs. They will not be accepted in place of this application form. All information provided will be treated confidentially and in line with GDPR regulations. Once completed, click submit or email the saved form to hr@trustlinecare.co.uk. Personal Details Title (Mr, Mrs etc.) * Select... Mr Mrs Miss Ms Dr Other First name * Last name * Date of Birth Sex * Select... Male Female Other / Prefer not to say Please specify if other Address * Mobile Phone * Landline Email address * NI Number Do you have the legal right to work in the UK? Yes No If not, please provide details of visa or sponsorship requirements: How did you hear about this job? Select... Indeed Reed Totaljobs Facebook Word of mouth Existing employee referral Company website Other If you were told about this job by someone that works for us, please tell us their name: If Other, please specify: Do any other of your close friends or relatives already work for us? * Yes No If you answered 'yes', please give their names here: Can you prove that you are legally entitled to work in the UK? * Yes No If you answered 'yes', what document/s will you provide to prove this? Have you worked recently in a care support role? * Yes No If you answered 'yes', what was your standard hourly rate of pay? Driving Licence Do you hold a current and full UK driving licence? Yes No If yes, is it clean (i.e. no endorsements or penalty points)? Yes No Please list any endorsements or restrictions (if applicable): Part 2 – Availability It is really important to us that we know when you are available for work so please do your best to ensure that the information you provide in this section is correct. What is the earliest date you could start work with us? * Do you have any holidays etc. already booked? * Yes No Departure Date Resumption Date Do you have the use of your own vehicle for work? * Yes No Please detail your availability Day Morning Lunchtime Teatime Evening Monday Tuesday Wednesday Thursday Friday Saturday Sunday Is there anything else we should know about your availability? Part 3 – Skills and Qualifications Please tell us about the languages you can speak and/or write: * Do you have an NVQ/QCF level 2 (or above) in Health & Social Care? * Yes No Have you completed the Care Certificate (England only)? * Yes No Please tell us about any other relevant formal qualifications you have achieved (including any Maths or English qualifications) * When did you leave full-time education? * Please mention any specific skills, experience, and achievements you can offer which meet the requirements of the job description and person specification. These skills/experience/achievements may have been gained in your current or previous employment, education, training, domestic activities, voluntary work, leisure interests etc. * Short Written Statement – Please provide a short statement (300–500 words) explaining: * • What qualities are important when working in care • How you support vulnerable individuals • Any relevant experience you haveYou may include real examples. Part 4 – Work History 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). You may use extra sheets if you need more space. Please start with your current or most recent employment and work backwards. Employment Entry 1 Start Date End Date Employer name and location (or educational establishment) Your job role (or, if studying, your course) Why you left (if applicable) Employment Entry 2 Start Date End Date Employer name and location (or educational establishment) Your job role (or, if studying, your course) Why you left (if applicable) Please explain any gaps in your employment (e.g. study, travel, family, illness): Disciplinary Record 📌 Providing false or misleading information may result in the withdrawal of a job offer or disciplinary action if appointed. Please declare any disciplinary action taken against you in previous or current employment. This includes formal warnings, suspensions, or any investigations or proceedings related to your conduct or performance. Employer Date Details Outcome I confirm that I have not been subject to any disciplinary action in previous or current employment. I have disclosed all relevant disciplinary matters above. Part 5 – Referees Please provide the details of four people that we can write to for a reference. 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 four 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. You must not give the names of friends or relatives or colleagues that are/were not senior to you as referees. All references will be verified. Referee 1 (Current / Most Recent Employer) Referee's name Position Name of organisation, school or college Address and Post Code Phone Email Start date of Employment / Study (if applicable) End date of Employment / Study (if applicable) May we contact this referee before interview? Yes No Referee 2 Referee's name Position Name of organisation, school or college Address and Post Code Phone Email Start date of Employment / Study (if applicable) End date of Employment / Study (if applicable) May we contact this referee before interview? Yes No Referee 3 Referee's name Position Name of organisation, school or college Address and Post Code Phone Email Start date of Employment / Study (if applicable) End date of Employment / Study (if applicable) May we contact this referee before interview? Yes No Referee 4 Referee's name Position Name of organisation, school or college Address and Post Code Phone Email Start date of Employment / Study (if applicable) End date of Employment / Study (if applicable) May we contact this referee before interview? Yes No Part 6 – Criminal Record Care workers work with vulnerable people and we take our responsibility to protect them very seriously. Your appointment will depend on the satisfactory completion of a criminal records disclosure (see policy statement below), but at this stage, we need you to answer the following questions truthfully and honestly: Have you received any convictions, cautions, reprimands or final warnings that are not 'protected' as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013 by SI 210 1198)? * Yes No To your knowledge, are you currently the subject of any criminal proceedings (for example, charged or summoned but not yet dealt with) or any police investigation? * Yes No If you answered 'yes' to either of the two previous questions, please provide details: Do you consent to our applying for an enhanced criminal records disclosure on you and to our retaining a copy of your disclosure certificate during the period of your employment or until a new disclosure is completed (whichever occurs first)? * Yes No Have you ever been barred from working with vulnerable adults or children? Yes No Are you currently subject to any investigations or restrictions? Yes No Is there anything that may affect your suitability to work with vulnerable individuals? Yes No If yes, comment: Criminal records disclosures – our policy As an organisation assessing applicants' suitability for positions which are included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order using criminal record checks processed through the Disclosure and Barring Service (DBS), we comply fully with the Code of Practice and undertake to treat all applicants for positions fairly. We will not discriminate unfairly against any subject of a criminal record check on the basis of a conviction or other information revealed. We can only ask an individual to provide details of convictions and cautions that we are legally entitled to know about. Where a DBS certificate at either standard or enhanced level can legally be requested (where the position is one that is included in the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended) and where appropriate Police Act Regulations (as amended), we can only ask an individual about convictions and cautions that are not protected. Note that if, once a criminal records disclosure has been completed, it is discovered that you have failed to accurately disclose the information requested above, the company reserves the right to terminate your employment without notice. Please be aware, however, that your having a criminal record will not necessarily mean we cannot employ you – if you would like to know more about our policy on the recruitment of ex-offenders, please ask. Part 7 – Suitability for the Job Please read the care worker job description and answer the following questions. The position for which you are applying requires physical effort (including sitting, standing, carrying, walking, moving and handling people), mental effort (including dealing with emergencies and short-notice changes to work in a fast-paced environment) and possible emotional/psychological effort (including dealing with bereavement and challenging behaviour in a potentially stressful environment). Have you read and understood the care worker job description? * Yes No Do you have any health conditions that would prevent you from meeting these intrinsic requirements for which the company might need to make reasonable adjustments? (If yes, please be aware that we may need to discuss these with you at your interview) * Yes No Comment: Do you require any reasonable adjustments for work or the recruitment process? * Yes No Comment: Do you require any training or support to carry out this role? Yes No If yes, specify: Equality and Diversity We are an equal opportunities employer. We welcome applications from all individuals regardless of age, disability, gender identity or expression, marital or civil partnership status, pregnancy or maternity, race, religion or belief, sex, or sexual orientation. All recruitment decisions are made fairly, transparently, and based solely on merit, skills, and experience relevant to the role. We are committed to creating an inclusive and supportive working environment where every applicant and employee is treated with dignity and respect. If you require any reasonable adjustments to support you through the recruitment process, please let us know and we will be happy to assist. Ethnic Background * Select... White – British White – Irish White – Any other White background Mixed – White and Black Caribbean Mixed – White and Black African Mixed – White and Asian Mixed – Any other Mixed background Asian or Asian British – Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – Any other Asian background Black or Black British – Caribbean Black or Black British – African Black or Black British – Any other Black background Chinese Any other ethnic group Prefer not to say Please Specify Ethnic Background if Other: Religion or Belief Select... No religion Christian (including Church of England, Catholic, Protestant) Buddhist Hindu Jewish Muslim Sikh Any other religion Prefer not to say Please Specify Religion or Belief if Other: Part 8 – Declarations Please read the following statements carefully. If there is anything you do not understand, please ask before you sign at the bottom of the page. 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: The company may make checks to verify the information I have provided; 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; 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; The company will use the personal information I have provided to decide if I am suitable for the job I have applied for; 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; If my application is unsuccessful, the company will keep only basic information about me and destroy the rest; If my application is successful, my personal information will be used for legitimate purposes in relation to my work (my contract of employment, which I will sign before I start work, will include further details on how my information may be used); 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; Any offer of employment will depend on the receipt of satisfactory employment references and the satisfactory completion of a criminal records disclosure (see part six above); I will be liable for the cost of my initial criminal records disclosure but that the company will bear the cost of any future disclosures that need to be made; I will be required to complete a pre-employment induction training programme prior to my starting work with the company; 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 and any uniform given to me if I leave the company's employment within six months, and that this sum may be deducted from my wages. Signed * By typing your name, you are confirming the above declaration. Date * Submit Application Or email the completed form to info@trustlinecare.co.uk Please enable JavaScript for this form to work.
