Apply — TransCare Secure Services

Step 1 of 8

About You

Your personal and contact details.

Title

Full Name (including middle names) *

Home Address (House/Flat number, Street, Town) *

Town / City / County *

Postcode *

Email Address *

National Insurance Number

Date of Birth *

Mobile Number *

Telephone Number

Eligibility

Are you aged over 21?

Yes No

Are you a UK National?

Yes No

Right to Work Document(s) Specify documents confirming your right to work in the UK

Right to Work Status (if not UK national)

Visa Number (if applicable)

Driving

Do you hold a full current UK driving licence?

Yes No

Endorsements?

Yes No

Are you related to any current Transcare staff member?

Yes No

If yes, please specify:

Step 2 of 8

Position Applied For

Position Applied For *

Service Location

Where did you hear about us?

If other, please specify:

Current Employment

Current Job Title

Date Appointed (MM/YYYY)

Employer Name

Type of Employer

Notice Required

Employer Address

Briefly describe the main aspects of your current role

Reason for seeking other employment

Equality Act 2010

Under the Equality Act 2010, disability is defined as a physical or mental impairment that has a substantial and long-term adverse impact on your ability to carry out normal day-to-day activities. Is there anything you would like us to be aware of so we can make reasonable adjustments during the application / interview process?

Reasonable Adjustments Required Leave blank if none required. Tick below if you prefer not to say.

Prefer not to say

Step 3 of 8

Employment History

Start with the most recent prior to your current employment. Include voluntary work.

Previous Employer 1

Employer Name

Job Title

From (MM/YYYY)

To (MM/YYYY)

Salary

Reason for Leaving

Address

Briefly describe duties

Previous Employer 2

Employer Name

Job Title

From (MM/YYYY)

To (MM/YYYY)

Salary

Reason for Leaving

Address

Briefly describe duties

Previous Employer 3

Employer Name

Job Title

From (MM/YYYY)

To (MM/YYYY)

Salary

Reason for Leaving

Address

Briefly describe duties

Previous Employer 4

Employer Name

Job Title

From (MM/YYYY)

To (MM/YYYY)

Salary

Reason for Leaving

Address

Briefly describe duties

Additional employers / gaps in employment history

Step 4 of 8

Availability

If applying for part-time work, tick your available shifts below.

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
Mornings
Afternoons
Evenings
Nights

I understand this role may include shift work / unsociable hours

Yes No

I may be contacted for work on days I have stated availability

Yes No

Step 5 of 8

Qualifications & Professional Registration

Professional Registration (if applicable)

Registered Body / Organisation

Registration Number

Registration Date

Expiry / Renewal Date

Additional Information

Education & Qualifications

Qualification 1

School / College / University

Qualification Level

From (MM/YYYY)

To (MM/YYYY)

Qualifications / Accreditations (grades if known)

Qualification 2

School / College / University

Qualification Level

From (MM/YYYY)

To (MM/YYYY)

Qualifications / Accreditations (grades if known)

Qualification 3

School / College / University

Qualification Level

From (MM/YYYY)

To (MM/YYYY)

Qualifications / Accreditations

Additional qualifications relevant to the role

Step 6 of 8

Relevant Training

List any training courses completed that are relevant to the role applied for.

Training / Course Title	Location / Training Provider	Date Completed

Additional training information

Convictions

This post is exempt from the Rehabilitation of Offenders Act 1974. Convictions spent under that Act must still be disclosed and will be taken into account. Any information will be treated in strict confidence and only considered in relation to this application. In addition, you will be required to submit to a Disclosure and Barring Service (DBS) check.

Have you ever been convicted in a Court of Law and/or cautioned in respect of any offence?

Yes No Not Applicable

If yes, please provide details of any unspent criminal convictions (including motoring offences):

Declaration regarding Schedule 1 (Children Protection) offences:

Step 7 of 8

References

Please provide contact details of your current and most recent previous employer. If you have only one work referee, the second may be a character referee. None should be related to you.

Reference 1

Title

Full Name *

Business / Organisation Name

Address

Postcode

Email Address *

Telephone Number *

Relationship to Applicant

Reference 2

Title

Full Name *

Business / Organisation Name

Address

Postcode

Email Address *

Telephone Number *

Relationship to Applicant

I consent for Transcare Secure Services to contact the provided references without further approval.

Step 8 of 8

Supporting Statement & Declaration

Supporting Statement *

Declaration

Signing this application indicates that you have read the job description and any other information issued relating to the vacancy and can comply with the fundamental requirements of this role. It also confirms that all information given is accurate.

Incomplete or misleading information may, on discovery, result in summary dismissal or rejection of your application.

By submitting this form you give TransCare Secure Services Ltd permission to undertake checks and searches about you that are relevant to any regulatory checks that may be taken against us.

Privacy Statement: Transcare Secure Services Ltd. will only collect data for specified, explicit and legitimate use in relation to the recruitment process. Data will be held securely until the vacancy is filled, after which it will be deleted or retained in our database for future roles if you consent.

Full Name (as declaration signature) *

Date

I confirm that all information provided is true and correct, and I consent to Transcare Secure Services Ltd holding and processing my data for recruitment purposes. *

Application for Employment

About You

Eligibility

Driving

Position Applied For

Current Employment

Equality Act 2010

Employment History

Previous Employer 1

Previous Employer 2

Previous Employer 3

Previous Employer 4

Availability

Qualifications & Professional Registration

Professional Registration (if applicable)

Education & Qualifications

Qualification 1

Qualification 2

Qualification 3

Relevant Training

Convictions

References

Reference 1

Reference 2

Supporting Statement & Declaration

Application Received!