GN Wellsprings Care Services

Employment Application Form · Care Beyond Duty

Employment Application

Please complete every section. Your information is held securely and used only for recruitment and selection.

Data Protection Statement. The information collected on this form includes sensitive personal data, processed for the purposes of recruitment and selection. If you are successful, your data will be stored in our password-protected systems for the administration of your employment. If unsuccessful, your form will be destroyed after six months unless you direct otherwise.
Equality Statement. GN Wellsprings Care Services treats all current and potential employees equally, regardless of age, race, religion or belief, disability, gender, sexual orientation, or any other personal background.
How we use your information (privacy notice)

Who we are. GN Wellsprings Care Services Ltd (10 Regents Place, Rugby CV21 2PN) is the data controller for the information on this form. Contact us at info@gnwellspringscareservices.org.uk about anything in this notice.

Why we need it. To assess your application, take up references, check your right to work in the UK and, if you are offered a job, carry out an enhanced DBS check and set up your employment.

Our lawful basis. Taking steps at your request before entering into a contract of employment (UK GDPR Article 6(1)(b)) and meeting our legal obligations, for example right-to-work checks (Article 6(1)(c)). Information about health or disability that you choose to give in Section 5 is used only to make reasonable adjustments, under employment law (Article 9(2)(b) and the Data Protection Act 2018, Schedule 1). Criminal record information is handled through the DBS process only — please do not type conviction details on this form.

Who sees it. Only our management and recruitment staff. It is stored securely in our Microsoft 365 (SharePoint) records and our secure care-management system. We contact your referees only as described in Section 3. We never sell your information.

How long we keep it. If you are unsuccessful, your application and CV are destroyed after six months, unless you ask us to keep them for future vacancies. If you join us, they become part of your staff file.

Your rights. You can ask to see, correct or delete your information, or object to how we use it, by contacting us. If you are unhappy with how we have handled your information you can complain to the Information Commissioner's Office (ico.org.uk, 0303 123 1113).

Section 1 Personal Information

Next of Kin

PDF, DOC or DOCX · maximum 5 MB. If you do not have a CV, leave this blank — the employment history in Section 6 is enough.

Section 2 Employment Preference

Section 3 Referees

References are normally taken up for candidates selected for interview. One referee should be your current or most recent employer.

Referee 1 (current/most recent employer)

Referee 2

Section 4 Rehabilitation of Offenders

Our work involves the provision of care services to vulnerable adults. You are requested to provide details of all convictions, including those which would otherwise be considered as "spent". The disclosure of a conviction does not automatically mean your application will be rejected — every case is considered carefully on its merits. Records will be checked via DBS procedures.
Important. To protect confidentiality, please do not type conviction details here. Provide them on a separate sheet in a sealed envelope marked "Private and Confidential – Criminal Convictions" and attach it to your application. An enhanced DBS check will be required for all successful applicants. Providing false information is a disciplinary matter and may result in summary dismissal.

Section 5 Reasonable Adjustments

Section 6 Previous Employment (most recent first)

Add your previous jobs. Use "Add another job" for each role. Leave blank if you have no previous employment.

No previous jobs added yet.

Section 7 Gaps in Employment (optional)

If there are gaps in your employment, list the reason below. Skip any that don't apply.

Gap 1

Gap 2

Section 8 Personal Declaration

I declare that to the best of my knowledge the information provided above, and in any accompanying documents, is correct, and:

  • I give permission for any enquiries that need to be made to confirm such matters as qualifications, experience and dates of employment, and for the release by other people or organisations of such information as may be necessary for that purpose.
  • I give permission for the processing of the personal data contained in this form for employment purposes.
  • I understand that any false or misleading information could result in withdrawal of any offer or dismissal.

Section 9 Signature

Typing your full name below acts as your electronic signature.