Application form

Carer Application Form

UK-based roles. Fields marked with * are required.

Role & Availability

Role applied for

Earliest start date

Employment type

Preferred hours per week

Shift preferences

Personal Details

First Name

Last Name

Preferred name

Date of birth

Mobile Number

Email address

Address line 1

Address line 2

Town/City

County

Post Code

Eligibility & Compliance

Right to work in the UK?

If yes, basis

National Insurance number

NHS number

UK driving licence?

DBS status

If current, enter Service ID/Certificate no.

Experience & Training

Years of care experience

Care settings experience

Key skills (comma separated)

Training/Certificates held

Experience summary

References (professional)

Please provide two professional references. We will not contact them without your permission.

Referee 1 – Name

Relationship/Role

Phone

Referee 2– Name

Relationship/Role

Phone

You may contact my referees now

Upload documents

CV / Résumé (PDF or DOC/DOCX. Max 5MB)

Choose File

Right to work (passport/BRP) (Image or PDF. Max 5MB)

Choose File

Proof of address (Utility bill/bank statement (last 3 months)

Choose File

Training certificates (multi-upload)

Choose File

Adjustments (optional)

Let us know about any reasonable adjustments you may need for interview or work.

Equal Opportunities Monitoring (optional)

Used only for monitoring and improving our recruitment. Not seen by the hiring panel. You can select “Prefer not to say”.

Gender

Ethnic origin

Declarations & Consent

We process your data under UK GDPR. See our Privacy Notice.

I confirm the information provided is true and complete to the best of my knowledge.

I consent to the processing of my personal data for recruitment and pre-employment checks.

I understand a DBS check may be required for this role and consent to such checks.

Keep me informed about future roles.

How we use your data (GDPR)

Purpose: recruitment, right-to-work/DBS verification, and onboarding if successful.
Legal bases: consent (withdraw any time), contract/steps prior to contract, and legal obligation.
Retention: applications retained up to 12 months (or your policy) then securely deleted; successful candidates per HR policy.
Data minimisation: only necessary fields are required; Equal Opportunities fields are optional and anonymised.
Access: authorized HR/recruitment staff and vetted processors only.

Type your full name as a signature

Date / Time

You will receive a confirmation email once submitted, Questions? Email recruitment@yourorg.co.uk or call 01234 567890.

Stephsam Support & Care Ltd