LAK HEALTHCARE AGENCYIS AN EQUAL OPPORTUNITIES EMPLOYER
LAK Healthcare Agency Equal Opportunities Policy covers all employees, or potential employees, and embraces the principle that all people shall be treated equally, regardless of their age, gender, ethnic origin, nationality, colour, religion, marital status, sexual orientation, religion or belief, disability, or offending background.
Data Protection Act 1998:
Your signature on this document gives us the right, under the Data Protection Act 1998 to process the information you have given, including data of a sensitive nature, relating to your application for employment. Any processing of the data by us will be in accordance with our Policy and the processing principles set out in the Act.
A: PERSONAL DETAILS
*In line with UKBA guidance on the prevention of illegal working if you are to be engaged by LAK Healthcare Agency for temporary work, LAK Healthcare Agency we will need to verify and take a copy of your original ID documentation as evidence of your right to work in the UK.
Disclosure and Barring Service (DBS)
On application, you will be requested to complete a DBS Disclosure (formally known as a CRB check).
Please Note: If your current DBS is not registered on the Online Update Service, LAK Healthcare Agency will ask you to pay for this DBS check in advance.
You must be made aware that, by completing this application form you give consent for a third party to view your file for compliance or inspection purposes (e.g. CQC inspection, Home Office or Clients of Impressions Care).
Please also note that, by completing this application form you give consent for the contents of your DBS Disclosure to be shared with potential clients on the behalf of LAK Healthcare Agency.
B: NEXT OF KIN
C: EDUCATION & PROFESSIONAL TRAINING
D: EMPLOYMENT HISTORY / AND EXPERIENCE (Including any agency work)
Please provide details of all employment, beginning with your present or most recent job first
E: Training History (Please review the list provided below and advise if you have previously undertaken any of the training detailed)
F: ADDITIONAL QUESTIONS
G: Do you have any endorsements on your licence?
Please complete the section below to advice of other agencies you have previously worked for. Please detail the organisations where you were placed, and the dates of all associated assignments to those organisations. This information will enable us ensure we comply with any rights you may have under AWR.
H: JOB FLEXIBILITY
I: WORKING TIME DISCLAIMER
You have the option to opt out of the 48-hour working week limitation, as laid down in the Working Time Regulation 1998.
I understand that I may end this agreement by giving one week’s notice in writing to Impressions Care Agency Ltd
J: REFERENCES
Please provide details of 4 referees who we may approach with regards to this Job Application, which should cover 3years. These referees must NOT be members of your family, and one must be your present or most recent employer:
K: YOUR HEALTH AND FITNESS
L: REHABILITATION OF OFFENDERS
Please Note: Failure to disclose any convictions which are not “spent” may render you liable for dismissal.
M: BANK DETAILS
Please provide bank account detail, where you authorise LAK Healthcare Agency, to make payments for any work that you will do on behalf of the organisation. The bank details must be in your own name.
Please confirm these are your bank details and that you authorise LAK Healthcare Agency, to make payments for any work that you will do on behalf of the organisation.
N: DECLARATION BY JOB APPLICANT
EQUALITY AND DIVERSITY MONITORING FORM