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(please mark appropriate suitability)
SOCIAL
WORKER

 SENIOR
PRACTITIONER		 DUTY
MANAGER
ASSISTANT
TEAM MANAGER

 TEAM
MANAGER		 SERVICE
MANAGER
HEAD OF
SERVICES

 OTHER  

Title:

Surname:

Full First Names:

Postal address:

CONTACT TELEPHONE NUMBER: (please include full dialling codes)

Home:


Work:

Mobile:

Email:

Date of birth:


Nationality:

Eligibility to work in the UK (if not British):

Do you need a work permit:

Current Visa Status:


Do you have a drivers licence:

Endorsements:

Do you have a car for work purposes:


Do you suffer form any disabilities or serious illnesses (please give details):


CURRENT EMPLOYER:

Address:

Position:

Notice period required to serve:

Desired start date:
   
PROFESSIONAL REFERENCES REQUIRED:

(3 professional references will be required covering your last 3 positions OR last 5 years)

   
CURRENT EMPLOYER:  

Name of Referee:

Title/Position

Name of Organisation:

Address:

Contact telephone numbers: Work

Other

Email address:

Fax no:

Dates: from		   To  

Reason for leaving:

Can we contact this person now for a reference?



 
PREVIOUS EMPLOYER:

Name of Referee:

Title/Position:

Name of Organisation:

Address:

Contact telephone numbers: Work

Other

Email address:

Fax no:

Dates: from		   To  

Reason for leaving

Can we contact this person now for a reference?






REHBILITATION OF OFFENDERS ACT 1974
(EXEMPTIONS ORDER 1974)
   
Due to the nature of work for which you are applying, the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 (Exemptions) (Amendment) Order 1986 are applicable.
Applicants are therefore required to give information about any convictions which for other purposes are "spent" under the provisions of the Act. Any information given will be completely confidential and will be considered only in relation to the application for positions to which the order applies.

Please provide full details of any/all convictions below:
   
CHECKLIST OF ACCOMPANYING DOCUMENTS:

1. Completed Application form

2. Up to date Curriculum Vitae (See CV Builder attached)

3. Copies of all Qualifications

4. Copy of Identification (passport or photo ID)

5. Copy of GSCC Registration Certificate

6. Copy of current CRB or Police Clearance Certificate

7. Passport size Photograph

8. Copy of any References you already have

9. Copy of current Eligibility (visa and/or work permit)

10. I have checked and Signed this Application Form


I declare the above information submitted by myself is, to the best of my knowledge true and correct.

I acknowledge that the information provided may form part of QSW UK's database to which I will have access as determined by the Data Protection Act 1984.

I acknowledge that if any information provided by me is found to be false, that my application can longer be considered and will not be put forward to relevant vacant positions.

I acknowledge and consent to QSW UK sharing my details and above information with any potential employers, and act on my behalf in securing and negotiating and offers of employment for me.
Name of Applicant:  
Signature:  
Date:  
   
*Please return completed application pack to info@qswuk.co.uk
or alternatively mail to
QSW UK, Suite 66, 19-21 Crawford Street, London, W1H 1PJ, England
Site Designed By: GRAPHICS 4 LESS
2007 Allrights Reserved by QSW UK.