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About Us
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Remote Support
Contact us
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Application
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Personal Information
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Step
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Please ensure you complete the application form in full. This form will be kept in confidence. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural/religious/political belief, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship.
Due to the dynamic nature of the care industry, consultants may be required to work any five days between Monday and Sunday. Are you able to commit to working for at least one weekend per month?
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Yes
No
Name
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First
Last
Email
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Date of Birth
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Phone
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Address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
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Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
Cayman Islands
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Chad
Chile
China
Christmas Island
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Colombia
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Congo
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Cook Islands
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Croatia
Cuba
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Côte d'Ivoire
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Morocco
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Samoa
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Slovakia
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Tuvalu
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Ukraine
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United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Under the Equality Act 2010 the definition of disability is if you have a physical or mental impairment that has a 'substantial' and 'long-term' adverse effect on your ability to carry out normal day-to-day activities. Do you consider yourself to have a disability?
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Yes
No
Are you having, or waiting for, treatment or investigation of any kind at present?
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Yes
No
Have you ever left a previous employment through ill-health or a work related injury or condition?
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Yes
No
Do you have any back, neck or joint problems causing difficulty with standing, walking, bending, lifting or stair climbing?
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Yes
No
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This section is for detailing any training courses you have attended which are relevant to this role. Please note that evidence of attendance to the course will be required. If you haven't done any training relevant to this role then please skip to the next section.
Have you attended any training courses/ have any qualifications which are relevant to this role?
Yes
No
If you haven't please answer 'No' and go to the next section
Name of qualification
Date Completed
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Add Another Qualification
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The CQC requires that carers disclose a full employment history, together with a satisfactory explanation of any gaps in employment. A “full employment history” means a career history from the age of first employment. In this section please outline all periods of employment or self-employment (whether or not related to health or social care), showing beginning and end dates, together with an explanation of periods of non-employment.
Employment History
Add History
Education
Employment
Unemployment
Reason for unemployment
Illness
Made Redundant
Traveling Abroad
Looking for work
Looking after children
Other (please explain)
Please provide further detail
Period of unemployment Start Month/Year (DD/MM/YYYY)
Period of unemployment End Date/Year (DD/MM/YYYY)
Name of School/College/University
Qualifications Obtained
School/College/University Start Month/Year (DD/MM/YYYY)
School/College/University End Month/Year (DD/MM/YYYY)
Position Held
Name of employer
Employer Address
Employment Start Month/Year (DD/MM/YYYY)
Employment End Month/Year (DD/MM/YYYY)
Nature of business/ Industry
Reason for leaving
Salary / Rate
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Add More History
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Remove
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You must provide references from your two most recent employers. Please provide a character reference 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 of the fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.
Employer Reference
Name
First
Last
Job Title
Address
Phone
Email
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Add Another Employer Reference
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Character Reference
Name
First
Last
Address
Phone
Email
Relationship to you
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Add Another Character Reference
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What is your motivation for working for Care Cuddle and working in the health and social care industry?
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What is your knowledge and experience of working in Health or Social care
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What are your strengths?
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What are your weaknesses?
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Use this link: hhttps://www.systemrequirementslab.com/my-computer-details to test your laptop/pc performance and upload a screenshot of the result
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Click or drag files to this area to upload.
You can upload up to 3 files.
Use this link: https://www.speedtest.net to test your internet speed and upload a screenshot of the result
*
Click or drag files to this area to upload.
You can upload up to 3 files.
How reliable is your power supply
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Completely reliable
Mostly Reliable
Unreliable
Please confirm that you have a quiet area to work from in your home
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Yes
No
A quiet work environment is essential for remote work.
Please advise of any challenges you may face working remotley
*
Next
Ex-Offenders Declaration Please note this section will only be seen by those involved in the recruitment process and will be treated with the strictest of confidence. Rehabilitation of Offenders Act 1974 Care Cuddle Ltd aims to promote equality of opportunity and is committed to treating all applicants fairly regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. Care Cuddle undertakes not to discriminate unfairly against applicants on the basis of 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 particular circumstances.
Are you currently bound over or do you have any current UNSPENT criminal convictions that have been issued by a Court or Court-Martial in any country?
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Yes
No
Do you have any current UNSPENT police cautions, reprimands or final warnings in any country?
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Yes
No
Next
By signing this application I acknowledge that 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 by Care Cuddle. Where applicable, I consent that Care Cuddle can seek clarification regarding professional registration details.
Signature (required)
Clear Signature
Date / Time
*
Data Protection Statement
Care Cuddle Ltd will only collect data for specified, explicit and legitimate use in relation to the recruitment process. By signing this application form, you consent to Care Cuddle holding the information contained within this application form. If successfully shortlisted, data will also include shortlisting scoring and interview records. We would like to keep this data until the vacancy is filled. (We cannot estimate the exact time period, but we will consider this period over when a candidate accepts our job offer for the position for which we are considering you). When that period is over, we will either delete your data or inform you that we would like to keep it 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 kept informed about the processing of your data. If you would like to discuss this further or withdraw your consent at any time, please contact hello@care-cuddle.co.uk
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