Email: info@ambiencecare.co.uk, Head Office: 0333 880 6881
Refresh
1
2
3
4
5
6
Simply complete your application in six easy steps !!
Personal Informations
Title
:
Consultant Name
:
First Name
*
:
Surname
*
:
Mobile Number
*
:
Email
*
:
DBS Ref. No.
*
:
DBS Issuse Date
:
Address
:
Do you consider yourself disabled?
:
Yes
No
CV Attached
*
:
Yes
No
(Official Use) Eclipse Ref.
:
Registration Date
:
Driving Lience (Full/Prov)
:
Yes
No
Own Car
:
Yes
No
National Insurance No.
*
:
How did you hear about Ambience?
:
Any Criminal Record
*
:
Yes
No
Post Code
:
Date of Birth
*
:
APPLICANT REGISTRATION - HCA/SUPPORT WORK : (Section 2 - Work Preference & Availability)
Day
Day Shift
Time
Night Shift
Time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Bank
Bank Details
Bank/Building Society:
*
Self-Employed UTR No.
Ltd Candidate: Company Name & Registration
Sort Code:
*
Account Number:
*
Account Name:
*
NEXT OF KIN(NOK) DETAILS
NOK Name
*
NOK Address
*
NOK Mobile:
*
NOK Email:
*
NOK Relation with Candidate:
*
Select Relation with Candidate
Husband
Wife
Friend
Partner
Brother
Sister
Candidate
Signature
Registered as: AMBIENCE CARE LIMITED, Company No: 10139214
×
Add New Reference Info
Reference Name
Reference Email
Reference Phone
×
Update Schedule
Branch Name
:: Update Branch Name ::
Slough Care
Surrey
Training
Phoenix
Reading
Stratford
Slough Education
Keystone
CQC
Consultant ID
Consultant Name
Responsibility
:: Select Emp. Responsibility ::
Consultant
Service Manager
Branch Manager
Account Manager
Country Manager
Regional Director
Deputy Manager
Diretor
Address
Emp. Salary (£)
Bank Name
Account Number
Joining date
×
Deleting...
DELETE SCHEDULE
