Pillarays Living Care

Position Details

Position Applying For *

Employment Type *

Available Start Date *

How did you hear about us? *

Personal Information

Title *

First Name *

Middle Name

Last Name *

Have your surname changed since birth?

Previous Surname (If Applicable)

Mother's Maiden Name *

Date of Birth *

Gender *

Nationality *

National Insurance Number

Marital Status

Contact Information

Email Address *

Mobile Number *

Home Telephone

Address Line 1 *

Address Line 2

Town / City *

County *

Postcode *

Emergency Contact Name *

Relationship to You *

Emergency Contact Number *

Preferred Method of Contact *

Right to Work & Eligibility

Do you have the legal right to work in the UK? *

Immigration Status *

Visa Type (If Applicable)

Visa Expiry Date

UK Share Code (If Applicable)

Passport Number

Do you require visa sponsorship? *

Do you hold a full UK Driving Licence? *

Do you have access to your own vehicle?

Are you willing to travel as part of your role? *

Education, Qualifications & Care Experience

Highest Qualification *

Do you have the Care Certificate?

Years of Care Experience *

Current Employment Status *

Professional Training & Certificates

Why would you like to work for Pillarays Support Services? *

Employment History

Current / Most Recent Employer *

Job Title *

Employment Start Date *

Employment End Date

Employer Telephone

Employer Email

Main Duties & Responsibilities *

Reason for Leaving (or reason for wanting to leave) *

Please explain any gaps in your employment history.

Professional References

Please provide details of two professional referees. One should preferably be your current or most recent employer.

Referee 1 Full Name *

Job Title *

Company / Organisation *

Relationship to You *

Telephone Number *

Email Address *

Referee 2 Full Name *

Job Title *

Company / Organisation *

Relationship to You *

Telephone Number *

Email Address *

May we contact your current employer before an offer of employment?

Supporting Documents

Please upload the relevant documents to support your application. Files should be in PDF, DOC, DOCX, JPG or PNG format.

Curriculum Vitae (CV) / Resume *

Cover Letter (Optional)

Proof of Right to Work (Optional)

Qualification Certificates (Optional)

DBS Certificate (If Available)

Declaration & UK GDPR Consent

I declare that the information I have provided in this application is true, complete and accurate to the best of my knowledge. I understand that providing false or misleading information may result in my application being withdrawn or, if employed, disciplinary action including dismissal.

I authorise Pillarays Support Services to verify the information provided, obtain employment references and carry out any pre-employment checks required for this role, including DBS checks where applicable.

I have read and understood the Privacy Notice and I consent to Pillarays Support Services processing my personal information for recruitment purposes in accordance with the UK General Data Protection Regulation (UK GDPR).

Electronic Signature (Type Your Full Name) *

Date *

Support Worker Application Form

Employment Application Form

Position Details

Personal Information

Contact Information

Right to Work & Eligibility

Education, Qualifications & Care Experience

Employment History

Professional References

Supporting Documents

Declaration & UK GDPR Consent

Support Worker Application Form

Employment Application Form

Position Details

Personal Information

Contact Information

Right to Work & Eligibility

Education, Qualifications & Care Experience

Employment History

Professional References

Supporting Documents

Declaration & UK GDPR Consent

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