Employment Application Form

Title —Please choose an option—Mr.Mrs.MissMsOther

What is your full name?

If other, please confirm here

What is your preferred name?

Your Gender —Please choose an option—MaleFemale

Date of Birth

What is the best number to reach you on? (Mobile is usually best)

What is your email address?

What is your home address?

What is their name?

What is their relationship to you?

What is their email?

What is the best number for them?

What is their address?

Which of these are you currently working as? —Please choose an option—Band1Band2Band3Band4Band5Band6Band7Band8

What is your professional Registration? —Please choose an option—RGNRCNRMNRMRNLDODPOther

Please confirm which areas you have worked in the past 12 months (please tick all that apply) HospitalCommunityPrisonResidentialNursing HomeCare in the home

What is your NMC/HCPC Pin Number (Type N/A if not applicable)

What is your Union Name (Type N/A if not applicable)

What is your Union Membership Number? (Type N/A if not applicable)

Expiry Date of Union Membership? (leave blank if not applicable)

Qualification/ Certification

Place of Study

Grade/Result

Year Completed

Most Recent Study

Previous study 1

Previous study 2

The role(s) you are applying for will require a Disclosure and Barring Service (DBS) enhanced check or Protective Vulnerable Groups (PVG) Scotland check prior to and annually thereafter, for work in Regulated Activity with vulnerable adults and/ children.

Rehabilitation of Offenders Act and Unspent Criminal Convictions: The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) Exceptions Order 1975 (2013), (2016 Scotland) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers and cannot be taken into account. Guidance and criteria on the protective filtering of cautions and convictions can be found by contacting the disclosure service

DBS Update Service: If you are currently subscribed to the DBS Update Service, do you give us permission to check the certificate? YesNo

If you have answered yes to the section as above, then please complete the following; I understand VCareConsultancy will require further information to assess my application and suitability for roles with clients. If my application is progressed I hereby give VCareConsultancy permission, to share the content of my DBS/ PVG/Access NI certificate with clients/organisations for the purpose of securing temporary work for me. I Agree

Failure to declare information that is later found to be held on your DBS, PVG or Access NI, may require us to exclude you from our register, discontinue your application, or terminate an assignment if an offence is not declared but later comes to light. Any information given will only be considered in relation to your application for regulated activity positions with our clients and will be managed in accordance with the DBS Code of Practise and Disclosure Scotland code of Practise for PVG. If applying to work in England and/or Wales (DBS): Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) YesNo

Date of your most recent appraisal? (leave blank if not applicable)

What is the name of your apprasier? (leave blank if not applicable)

Employer 1 (current / most recent employer)
Employer Name Start Date End Date Job Title Roles/Responsibilities Reason for Leaving

Employer 2 (please leave empty if not applicable)
Employer Name Start Date End Date Job Title Roles/Responsibilities Reason for Leaving

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Employer 3 (current / most recent employer)
Employer Name Start Date End Date Job Title Roles/Responsibilities Reason for Leaving

Employer 4 (please leave empty if not applicable)
Employer Name Start Date End Date Job Title Roles/Responsibilities Reason for Leaving

If you are applying for a post that requires professional registration you are required to provide the following information:

Have you ever been suspended or terminated from a Health or Social Care role? YesNo

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Are you currently the subject of a fitness to practise investigation or proceedings by a licensing, regulatory body or other organisation in Ireland or in any other country? YesNo

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Have you been removed from the register or have any conditions been made on your registration by a fitness to practice committee or the licensing or regulatory body in Ireland, or in any other country? YesNo

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If you have answered yes to any of the above questions, then please provide further details:

The European Union has laid down guidelines for all workers, governing the length of the maximum working week that is safe to work. The current limit is 48 hours per week. You are under no obligation to accept any work offered, and you will not be compelled to work more than 48 hours per week, however you may choose to do so. A full explanation of the Working Times Regulations 1998 can be found in your Staff Handbook.

Please select as appropriate:
I do NOT wish to work more than 48 hours per week. Due to the nature of temporary work I understand that VCareConsultancy cannot monitor work patterns outside of VCareConsultancy’s control and therefore it is my responsibility to monitor this.I DO wish to work more than 48 hours per week.

Legal Compliance: I understand that VCareConsultancy retains the right to hold this application and any other data, including data that is considered ‘personal’ and/ ‘special’ that is required to process for the purpose of complying with their legal obligations of my recruitment and supply to suitable assignments with contracted clients, and to retain these details for as long as reasonably necessary in accordance with the General Data Protection Regulation (GDPR)(Regulation (EU) 2016/679) and our contractual obligations.

I consent to VCareConsultancy processing data outside of the European Economic Area (EEA) in their secure processing centres in India and South Africa.
YesNo

Please Note: If consent is not given for processing your data outside the EEA, we will be unable to progress your application and will destroy all records held

As part of our service, we would also like to offer you relevant professional information, including:

- Useful news and features about your profession
- Events, competitions and promotions we are running
- Surveys and opportunities for you to offer your views and insights
- Ongoing career opportunities during breaks of 12 months or more from temporary work assignments with us.

We may use your email, postal address, mobile number and/or job title information to send you the most relevant career opportunities. Please let us know how you prefer to be contacted for marketing purposes. please select as applicable:
EmailSMS/Instant MessagingTelephone

Please Note: If consent is not given for processing your data outside the EEA, we will be unable to progress your application and will destroy all records held

Whilst working for the agency, the temporary worker will accumulate Holiday Pay calculated as a percentage of the hourly rate of pay.
We co-ordinate leave from April to April. All requests must be made within the correct time period.
Should you submit a request later than 31st March you will no longer be entitled to holiday pay for the previous year.
If applying for holidays, the temporary worker must give a minimum of 1 weeks notice to the Registered Manager or Sales Manager at the agency.
I have read, understand and will comply with the Working Holiday Entitlement Clause.
For the purposes of your employment with us, the holiday year will be the 12 month period commencing on the 6th April (and, if applicable, each subsequent 12 month period).
All entitlement to leave must be taken during the course of the holiday year in which it accrues and none may be carried over into the next holiday year.
The agency is not required by law to make any payment in lieu of unused holiday at the end of the holiday year.
When making your holiday plans please observe the following:
You should not normally plan to take more than two weeks at any one time although a longer period may be granted in special circumstances.
Notice must be given of either 1 week or equivalent to the total length of the holiday, whichever is the greater.
I agree

Danbro Accounting LTDJSA Services LTDGiant ProfessionalOther* - Please provide Umbrella Company Name *Subject to approval by VCareConsultancy prior to payment method being approved.

Umbrella companies are required to comply with IR35 guidelines. Please check with your consultant if you Umbrella company meets these requirements.

Please confirm that you:
Agree to the terms and conditions of the above selected Umbrella company.Understand that registration with my chosen Umbrella company is my responsibility and that a delay in registration may delay payment.Consent to ICG sharing your personal details with your chosen Umbrella company for payment for work completed. *Subject to approval by VCareConsultancy prior to payment method being approved.
Umbrella companies are required to comply with IR35 guidelines. Please check with your consultant if you Umbrella company meets these requirements.

Payee Name (as it appears on your account)

Account Number

Sort Code

Our Terms & Conditions for working with us can be viewed online by copying and pasting this link into your brower https://vcareconsultancy.com Please confirm you have read and understood these T&C I confirm