Online Application | Rosecare Community Services

Please make sure to fill in all the fields (*) below.

Last Name*

First Name*

Email Address*

Phone Number*

Select staff position *

Street address*

City*

State/Province*

Country*

Date of Birth*

Are you a Student?*
Yes No

Do you hold a full, clean driving license valid in the UK?*
Yes No

Did you ever get employed in the last 5 years?*
Yes No

Please complete 5 years employment history with no gaps below.

Company name*

Company email address*

Company phone number*

Street address*

City*

State/Province*

Zip Code*

Country*

Please state Date Started & Date Ended and Summary of responsibilities and/or achievements: *

Please make sure to fill in all the fields (*) below.

Please state below the names and addresses of two referees (including your current or last employer) and covering at least three years of employment. These people will only be contacted if a job offer is made and verbally accepted by you. Referees should not be relatives or friends. We reserve the right to contact any previous employer or education establishment mentioned on this application.

Reference 1

Reference Full Name*

Reference Job Title*

Reference email address*

Reference phone number*

Street address*

City*

State/Province*

Zip Code*

Country*

Reference 2

Reference Full Name*

Reference Job Title*

Reference email address*

Reference phone number*

Street address*

City*

State/Province*

Zip Code*

Country*

Please make sure to fill in all the fields (*) below.

Because of the nature of the work for which you are applying, this post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. Applicants are therefore not entitled to withhold information about convictions or cautions whichfor other purposes are “spent” under the provisions of the Act, and in the event of employment, any failure to disclose such convictions orcautions could result in dismissal or disciplinary action by the Agency. Any information given will be completely confidential and will beconsidered only in relation to applications for positions to which the Order applies.

Do you have any criminal convictions that have not become spent under the Rehabilitation of Offenders Act 1974 and/or any offences for which you are currently awaiting a court appearance?*
Yes
No

Have you ever been disqualified from the practice of a profession or to practice under specific limitations?*
Yes
No

Do you have any cautions that have not become spent under the Rehabilitation of Offenders Act 1974 and/or any offences for which? you are currently awaiting a Court appearance? *
Yes
No

Has your employment or contract ever been terminated or suspended – in the UK or abroad – on grounds relating to your fitness to practice (conduct or performance)?*
Yes
No

Data Protection Act 1998: This application form has been designed to provide us with sufficient basic information to carry out a preliminary assessment of your suitability for the post. The information you supply in this form is confidential and will only be used by those involved in the appointment inline with the Data Protection Act 1998.
By signing below, I confirm that the information given on this form is, to the best of my knowledge, complete and correct. I understand that any incorrect or incomplete information may lead to my application being refused, my offer of employment being withdrawn, or termination of my employment should I have commenced work.

Signed by*

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Personal Information

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Documentation Upload

Please select the documents you are able to provide and upload them below.

Employment History

Please complete 5 years employment history with no gaps below.

References

Please make sure to fill in all the fields (*) below.

Reference 1

Reference 2

Criminal Convictions/Probity Declaration

Please make sure to fill in all the fields (*) below.

Declaration