Please fill in the job application form below and submit to send it through to Essential Homecare Services NI Ltd Please enable JavaScript in your browser to complete this form.Full Name (Fornames & Surname): *Maiden Name (if applicable):Position that you are looking to apply for: *Care Supervisor - Full TimeSocial Care Worker - Full TimeSocial Care Worker - Part TimeDementia Buddy - Full TimeDementia Buddy - Part TimeNational Insurance Number:Title (Mr/Mrs/Ms/Miss):Place of Birth:Date of Birth:Address (including postcode):Landline Number:Mobile Number: *Email *Next of Kin Details Please enter details of your next of kin. This is a person we can contact if you have an accident or illness while of duty.Name:Address:Contact Number:Relationship:Education Please provide all/any qualifications in the space provided.YearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeYearQualificationSubjectGradeExperience & Training Please use the space below to provide information of any experience or training relevant to the position applied for.Experience & TrainingEmployment History Please state below particulars of present and previous employment.Employer 1 (From, To, Duties, Reason(s) for leaving:Employer 2 (From, To, Duties, Reason(s) for leaving:Please be aware that any gaps in employments must be accounted for.References Please give names and addresses of two referees who are not related to you and have knowledge of your work. One must be from your current or most recent employer. REFEREE 1Name:Address & Postcode:Telephone Number:REFEREE 2Name: Address & Postcode:Telephone Number:General InformationDo you hold a current driving licenseYesNoDo you have access to a car for work purposes?YesNoIf appropriate, does your insurance cover you for business use?YesNoHave you ever been convicted of any criminal offence (including a motoring offence)? If yes please use the space below to give details.Is there any reason as to why you cannot work with children or vulnerable adults? If yes please use the space below to give details:Criminial Record Check In the event of a position being offered, the applicant will have to undergo an Access NI disclosure check with a cost to the applicant of £33.00Special ArrangementsDo you have or have you ever had a disability which you consider to be relevant to the post applied for? If yes please use the space below to give details.YesNoSpecial Arrangements Q1Do you require any special arrangements to be made for you to attend an interview if short listed? If yes please use the space below to give details.YesNoSpecial Arrangements Q2Warning An employee found to have knowingly given false or inaccurate information, or have wilfully failed to disclose any relevant fact will be dismissed. DeclarationI declare that to the best of my knowledge and belief that all information recorded in this application form is true:YesMessageSubmit