Home Number Email Address Nationality Do you require a Visa to work □ □ Yes No in the UK? Do you hold a full UK driving □ □ Yes No license? Do you own or have regular □ □ Yes No access to a vehicle for work? Do you have experience □ □ Yes No working in care? If Yes, how many If Yes, please briefly describe your experience □ People □ End-of-Life/Palliative □ □ Dementia Mental Health □ MS/MND □ Substance Misuse Please select the areas that you have experience in □ Physical Disabilities □ Reablement □ Learning Disabilities □ HCA e.g PEG, suctioning □ Sensory Impairment □ Children Have you ever been dismissed □ □ Yes No from a role in the Care sector? Are you applying in response to a specific advertised vacancy? If Yes, where did you see this vacancy? Availability
Home Number Email Address Nationality Do you require a Visa to work in the UK? Yes □ No □ Do you hold a full UK driving license? Yes □ No □ Do you own or have regular access to a vehicle for work? Yes □ No □ Do you have experience working in care? Yes □ No □ If Yes, how many If Yes, please briefly describe your experience Please select the areas that you have experience in □ People □ Dementia □ MS/MND □ Physical Disabilities □ Learning Disabilities □ Sensory Impairment □ End-of-Life/Palliative □ Mental Health □ Substance Misuse □ Reablement □ HCA e.g PEG, suctioning □ Children Have you ever been dismissed from a role in the Care sector? Yes □ No □ Are you applying in response to a specific advertised vacancy? If Yes, where did you see this vacancy? Availability
Application-Pack-Care-Supervisor.docx