Application for Employment

Application Form

"*" indicates required fields

Personal Details

Eligibility for Employment

Are there any restrictions on your right to work in the UK?
Evidence required of all passports and visas. Please note, Alliance Care Professionals will make copies of the originals at your first interview. All passports and visas are verified as part of our recruitment procedure.

Education & Professional Qualifications

Please provide all relevant training and qualifications, also indicate subjects currently being studied and expected year of qualification. All qualifications disclosed will be subject to a satisfactory check.
Date Graduated

Employment History

Please record below the details of your full employment history beginning with your current or most recent first. Please cover all reasons for gaps in any given year. If you need more space, please use the employment history sheet(s) at the end of this form.
Have you ever worked for the Alliance Care Professionals?
Employer name and address (Current/most recent employer)
Position held
Start date (MM/YYYY)
End date (MM/YYYY)
Reason for leaving (if applicable)


Please provide the names and full contact details of your referees. Referees may be contacted before interview unless you state otherwise below.

Referee 1 Details

Referee 2 Details

Can the referees be contacted prior to interview?

Criminal Convictions

Alliance Care Professionals Ltd is committed to safeguarding and promoting the welfare of its service users and expects all staff to share that commitment.
As the job for which you are applying involves substantial opportunity of access to vulnerable adults, it is exempted from the provisions of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Therefore, you are required to disclose any and all current or ‘spent’ criminal convictions, cautions, reprimands, bind overs or warnings you may have incurred, regardless of how long ago.
Do you have any convictions to disclose?
Any information should be given on a separate sheet and sent with this application form. This information will be treated as confidential and will not necessarily preclude you from employment. Failure to declare or the falsification of any of the above details will result in the withdrawal of any job offer.

Equal Opportunities

In accordance with equal opportunities statement, we provide equal opportunities to all employees and job applicants. We will not discriminate either directly of indirectly on the grounds of
• age and sex.
• race which includes colour, nationality, ethnic or national origin.
• religion or belief, including a lack of any belief.
• sexual orientation, be it bisexual, gay, heterosexual and lesbian.

Please indicate if you have any disabilities, please let us know if we need any adjustments when assisting you with your search for work.
According to the definition of disability do you consider yourself to have a disability?
Asian or Asian British
Other Ethnic Group
Black or Black British


The information in this 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 the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details

I agree to the above declaration
MM slash DD slash YYYY

General Data Protection Regulations

Privacy Notice and Consent form for Employees

In May 2018, the law changed about how employers record, store and use individuals’ personal data. As part of our recruitment process Alliance Care Professionals need to collect and hold data about you to enable us to process your application. We will share your personal data to third parties. We acknowledge and agree that any personal data of yours that we handle will be processed in accordance with all applicable data protection laws in force.

Alliance Care Professionals Ltd is registered with ICO (Registration – ZA563429) for processing your DATA. If you have a concern about the way we are collecting or using your personal data, you should raise your concern with us in the first instance or directly to Information Commissioners Office at https:\\\concerns.

Your consent is requested.

I would like your consent to hold personal and special data about you in order that I can process your employment contract. You are entirely in control of your decision to give consent to our use of your data as requested in this form. There will be no repercussions if you choose to withhold consent.

Please acknowledge receipt of the Alliance Care Professionals Ltd Privacy Notice and confirm that you have read and understood it. If you would like a copy, please let us know.

I agree to the above declaration