Contact Us ....

Application for Employment ....

All information will be treated as strictly confidential and no approach will be made to any person without your permission. Further information and forms will be requested at interview.

All questions marked with * are mandatory and must be answered.

Autonomy Care Application for Employment Form

Please select which company you have applied for a position with by ticking the relevant box:

Please enter the position you are applying for:

If you obtained this position, would you continue in any other employment?

Do we need to make any disability-related adjustments to allow you to take part in the recruitment process?

PERSONAL DETAILS

DRIVING LICENCE

Current Driving Licence? Yes or No. If Yes please add the type of licence

Any current endorsements? Yes or No. If Yes please give details

Any motoring prosecutions pending? Yes or No. If Yes please give details

CRIMINAL CONVICTIONS

List any criminal convictions other than "spent" convictions. If none, state "none".

The information provided will be confidential and will be considered only in relation to this application.

PREVIOUS EMPLOYMENT

Please list: Name and Contact Details of Employer, Dates, Job Title and Duties, Reason for Leaving

EDUCATION & TRAINING

Please list: School/College, Dates, Qualifications

REFERENCES

Reference 1 - Character Reference. Please list your Character reference and their contact details - Address, Postcode and Telephone details

Reference 2 - Work Reference. Please list your Work reference and their contact details - Address, Postcode and Telephone details

FURTHER INFORMATION

Please detail any further information you wish to put forward in support of your application:

DECLARATION

By submitting this application form I declare that the information I have given is true. I understand that any job offer made on the basis of untrue or misleading information may be withdrawn or my employment terminated.