Application Form

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Application Form

Application Form

Application Form - Step 1 of 5:

* is required

PERSONAL DETAILS

Please indicate which branch you would like to work in: *

Position applied for: *

Name in Full: *

NI NUMBER: *

For Criminal Record check purposes, addresses covering the five years up to the application date must be supplied

Current Address: *

Address Line 1:

Address Line 2:

City:

County:

Postcode:

Country:

Date moved to the above address:

/ /

Home Phone: *

Area Code:

Phone Number:

Mobile Phone:

Area Code:

Phone Number:

E-mail Address: *

Previous Address 1:

Address Line 1:

Address Line 2:

City:

County:

Postcode:

Country:

Date moved to the above address:

/ /

Previous Address 2:

Address Line 1:

Address Line 2:

City:

County:

Postcode:

Country:

Date moved to the above address:

/ /

Previous Address 3:

Address Line 1:

Address Line 2:

City:

County:

Postcode:

Country:

Date moved to the above address:

/ /

Own Transport?

No | Yes

Current Full Driving licence?

No | Yes

Provisional Licence?

No | Yes

Do you have any endorsements on your licence?

No | Yes

Do you have a current DBS check?

No | Yes

Are you on the DBS Update service?

No | Yes

If you have answered YES:

Please provide your Update Number:

Please give the date of when your last DBS check was carried out:

/ /

NEXT OF KIN

Next of Kin Full Name: *

First:

Last:

Next of Kin Relationship: *

Next of Kin Address: *

Address Line 1:

Address Line 2:

City:

County:

Postcode:

Country:

Next of Kin Phone: *

Area Code:

Phone Number:

CAPACITY TO WORK IN THE UK

Are there any restrictions to your status here in the UK that may affect your right to take up employment here:

No | Yes

If YES, please provide details:

Coastal Homecare: Compassionate, professional home care in Sussex. Supporting independent living with tailored care services, including hospital discharge, live-in care, and daily support. Trusted provider to Brighton & Hove City Council, West Sussex County Council and East Sussex County Council. Contact us today to explore your care options.

Coastal Homecare (Hove) Ltd
78 Goldstone Villas
Hove
BN3 3RU

01273 410471
info@coastalhomecare.co.uk

Modern Slavery Statement

Worthing Branch
115 George V Avenue
Worthing
BN11 5SA

01903 246651
Worthing.info@coastalhomecare.co.uk

Mid Sussex Branch
99 Church Walk
Burgess Hill
RH15 9BQ

01444 645030
midsussex.info@coastalhomecare.co.uk

We care, because you care

Application Form

Application Form

Application Form - Step 1 of 5:

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