Online Application

Do you want to work with us? Please fill in your details below.

Full Name
Full Address
Street Address
Enter Field Title
City
State / Province
Postal / Zip Code
Email *
National Insurance
Date of Birth
Applying for: Nursing/ Care Assistant/ Support Worker/ Social Worker/ Other
NMC Pin
Availability: Date
Additional Information
Where did you hear about us from: Our Website/Social Media/Search Engine

Emergency Contact Details - Next of Kin

Please provide details of your Next of Kin

Next of Kin - Full Name
Address
Street Address
Street Address Line 2
City
State/Province
Postal / Zip Code
Relationship: Spouse/Partner/Parent/Sibling/Other
Additional Information
Phone Number

Employment History

1. Current/Position Held
Organisation/Company
Date From:
Date To:
Reason for leaving
2. Current/Position Held
Organisation/Company
Date From:
Date To:
Reason for leaving
3. Current/Position Held
Organisation/Company
Date From:
Date To:
Reason for leaving
  • References

    Please provide the names and contact details of 3 professional references from your current and most recent employment, which must cover last 5 years of employment/education. Referees must have worked in a senior position to yourself. Please beware that Teesside Personnel is unable to offer work until satisfactory references have been obtained, that Magnus Care are required obtain references for you on annual basis.

Reference 1

Fullname
Phone Number
Email
Position
Organisation

Reference 2

Fullname
Phone Number
Email
Position
Organisation

Reference 3

Fullname
Phone Number
Email
Position
Organisation
  • Nationality and Eligibility to work

    Please provide/upload coloured SCANNED copies to the following email address: recruitment@threelittleangels.org
  • Updated CV
  • Mandatory or Care Certificates Scanned
  • Proof of address SCANNED
  • Proof of P45 or P60 SCANNED

Online DBS number
  • Disclosure of Criminal records

    Applications for healthcare positions are exempt from Rehabilitation of Offenders Act 1974. You are required to declare prosecutions or convictions including those considered 'spent' under this Act. Please tick the relevant to you:

Do you have any convictions: Yes/No
Describe The Conviction. If you do not have, leave it blank.
  • Working Time Directive

    The Working Time Regulations 1998 requires TLA Personnel to limit your average weekly working time to 48 hours unless you agree with TLA Personnel that the limited time shall not apply to you:

Do You Agree: Yes/No
  • Candidate Handbook

    Available upon request from recruitment@threelittleangels.org

I confirm that I received, requested, read and understood each section of the Candidate Handbook:

  • I can confirm that I have read this document fully and that all the information provided to TLA Personnel is correct and to the best of my knowledge and belief. I give consent to contact referees regarding the information I have provided unless specified otherwise.

  • I will inform TLA Personnel should anything change that might affect my position and I understand the information given on this form will be processed by computer and used for registration purposes, under the Data Protection Act 1998.

  • I understand that if I am at any stage charged or cautioned after signing this declaration, I must inform TLA Personnel.

  • I acknowledge that I have been given/requested a copy of the terms and conditions of service issued by TLA Personnel, which is mine to keep, and furthermore that I have read those terms and conditions and agree to abide by them.

  • I am not aware of any condition, medical or otherwise, which would affect or limit my employment or performance, other than those declared in my Occupational Health Form.
  • I acknowledge and confirm that TLA Personnel is authorised to apply for and obtain a Disclosure and Barring Service (DBS) check and references from any previous employers and educational establishments.
  • I declare that the information given herein is true and complete and is not presented in away intended to mislead. I agree that if I have given false or misleading information or omit to give relevant information now or in the future that TLA Personnel may cease to offer me further agency placements without notice, as well as claim for recovery of any payments I have received, together with a claim for loss of profit to TLA Personnel.

  • I agree that the maximum weekly working time specified in Regulation 4(1) and (2) of the Working Time Regulations 1998 shall not apply to working with TLA Personnel unless specified above.

  • I acknowledge that my personal details will be stored and handled correctly by TLA Personnel in accordance with the Data Protection Act 1998, however, I agree that they may be made available for audit/review by relevant third parties. (This is relevant for all information including all documents- DBS, Occupational Health, References).

  • I understand that if I am on a student visa I can only work for 20 hours per week during term time. I understand that I have a sole responsibility to monitor this. In addition, if my position as a student changes, I must inform TLA Personnel.

  • I understand that if I am on a Tier 2 Sponsorship Visa, I can only work for a maximum of 20 hours per week at the same professional level as my sponsorship. I understand that I have a sole responsibility to monitor this. In addition, if my position with my sponsored company changes, I must inform TLA Personnel.

  • I acknowledge that if any of my details stated on this Application Form change, or my circumstances change, which may affect my ability to work for TLA Personnel, I must inform TLA Personnel immediately.

  • I confirm that I am not currently under investigation, or currently suspended, by my professional regulatory body or being investigated by my current or previous employer. I will inform TLA Personnel if I am under investigation or suspended by my professional regulatory body or employer at any point while working for TLA Personnel

  • I confirm that when asked about my working history (primarily, but not exclusively, for the purpose of the Agency Workers Regulations) I will provide accurate information.

  • I acknowledge that should I reach the 12-week Qualifying Period under the Agency Workers Regulations, I may be asked for, and will provide, further documentation as evidence of qualifying weeks, if TLA Personnel deems it necessary.

Do You Agree: Yes/No

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