Thank you for your interest in joining Heart Link Health Care Services. Please fill in the application form below, providing as much information as you can. 13%Please ensure that you complete the application form in full as we cannot accept CVs. Please complete with black ink and block capitals. This form will be kept in confidence. Please note that no applicant will be unfairly discriminated against. This includes discrimination on account of age, cultural/religious/political beliefs, disability, ethnicity, gender, race, relationship status, sexual orientation, and/or Trade Union membership or stewardship. If you have any special requirements to support you to complete this form (e.g. the need for large print or additional time) please contact the manager on 01312351035.Position applied for:*Preferred employment type (e.g. part time, full time):*NamePlease selectMrMrsMsMissDrPrefixFirst NameLast NameCurrent Address:*Telephone number (home):Postcode:*Telephone number (mobile):Email address*Own Transport?*YesNoHow long has your licence been held?*Licence Number*Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National*YesNoType of VisaExpiry DateUploadNational Insurance Number:Are you are related to a member of staff or Service User / Clients at HEART LINK HEALTH CARE SERVICES LTD,*YesNoNextUnder the Equality Act 2010 the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at: www.gov.uk/definition-of-disability-under-equality-act-2010.For the purposes of this application and the interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process?*YesNoPrefer Not to sayPlease give details*BackNextSchool/College/University*Examinations Passed, Qualifications Gained and Year Obtained (All qualifications will be subject to a satisfactory check).*Training Courses Attended or CompletingSubject (evidence of attending courses is required)*Location*Date*BackNextName of your most recent/last employer:*Start Date*Position held and reason for leaving:*Nature of business:*End Date*Salary / Rate:*add previous Employer*YesNoName of your most recent/last employer:Start DatePosition held and reason for leaving:Nature of business:End DateSalary / Rate:BackNextPlease add here your reasons for applying. You should refer to the job description and person specification to guide you. It would also be of value to describe particular strengths and talents that set you apart from others as well as including skills gained from work, home and other activities.Supporting Statement*BackNextYou must provide references from your two most recent employers. Please provide a character reference if you are unable to obtain two professional references, e.g. in the case of an applicant who has been raising children for ten years. All will be contacted, therefore please inform the referees of the fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.Current or Most Recent Employer*Email address*Address*Job title:*Post Code*tel No:*Add Previous Employer?*YesNoName of Employer*Email address*Address*Job title:*Post Code*tel No:*BackNextPlease note this section will only be seen by those involved in the recruitment process and will be treated with the strictest of confidence.Rehabilitation of Offenders Act 1974 HEART LINK HEALTH CARE SERVICES LTD aims to promote equality of opportunity and is committed to treating all applicants fairly regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. HEART LINK HEALTH CARE SERVICES LTD undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared. Answering Yes to the question below will not necessarily prevent your employment. This will depend on the relevance of the information you provide in respect of the nature of the position and the particular circumstances.Are you currently bound over or do you have any current UNSPENT convictions that have been issued by a Court or Court-Martial in the United Kingdom or in any other country?*YesNoDo you have any current UNSPENT police cautions, reprimands or final warnings in the United Kingdom or in any other country?*YesNoHEART LINK HEALTH CARE SERVICES LTD will only collect data for specified, explicit and legitimate use in relation to the recruitment process. By signing this application form, you consent to HEART LINK HEALTH CARE SERVICES LTD holding the information contained within this application form. If successfully shortlisted, data will also include shortlisting scoring and interview records. We would like to keep this data until the vacancy is filled. (We cannot estimate the exact time period, but we will consider this period over when a candidate accepts our job offer for the position for which we are considering you). When that period is over, we will either delete your data or inform you that we would like to keep it in our database for future roles. We have privacy policies that you can request for further information. Please be assured that your data will be securely stored by the manager and only used for the purposes of recruiting for this vacant post. You have a right for your data to be forgotten, to rectify or access data, to restrict processing, to withdraw consent and to be kept informed about the processing of your data. If you would like to discuss this further or withdraw your consent at any time, please contact the manager or GDPR Officer on 01312351035.BackNextThe information in this application form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal if employed by HEART LINK HEALTH CARE SERVICES LTD. Where applicable, I consent that HEART LINK HEALTH CARE SERVICES LTD can seek clarification regarding professional registration details.Name*Date*BackSendThis field should be left blank