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Date of Application
Month
Day
Year

Important Notice

This service is committed to providing equality of opportunity in accordance with the Equality Act 2010. Applications are welcomed from all individuals who feel they can carry out the duties of the role.

Successful applicants will be required to undergo appropriate checks, including:

  • Disclosure Scotland / PVG checks

  • Verification that the applicant is not barred from working with protected adults

Disclosure information will only be used for recruitment purposes and will not automatically prevent employment. Any concerns will be discussed with the applicant before a decision is made.

 

Data Protection

All information provided will be processed in accordance with the Data Protection Act 2018.

Your data will be used to:

  • assess suitability for the role

  • meet safer recruitment requirements

  • support equality monitoring

If successful, your information will be retained within your employee record.

By signing this application, you consent to the processing of your personal data, including sensitive information where required.

Date of Birth
Month
Day
Year
Multi-line address
Date Moved to Address
Month
Day
Year

Contact Details

Do you hold a Valid Driving License
License Expiry Date
Month
Day
Year
Do you have a Vehicle for Work
Do you have Business Insurence

Questions

Employment History

Education and Training History

References

Reference 1 Is this your current employer

Health Declaration

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Planned Holidays

Equal Opportunities Monitoring Form Equality and Diversity Monitoring

This form is used for equality and diversity monitoring purposes only.

The information provided will be used to help the Company monitor fairness and equality within its recruitment and employment practices.

This form will not be used as part of the recruitment decision-making process.

Completion of this form is voluntary.

You may select Prefer not to say for any section.

Ethnic Background

Please select one option that best describes your ethnic background.

Please Select
Scottish
English / Welsh / Northern Irish / British
Irish
Other White background
White and Black African
White and Black Caribbean
White and Asian
Other mixed background
Indian
Pakistani
Chinese
Other Asian background
African
Caribbean
Other Black background
Arab
Hispanic / Latino
Other ethnic group
Prefer not to say
Age Range (Please Select)
16 - 21
22 - 25
26 - 30
31 - 35
36 - 40
41 - 50
51 - 60
61 - 65
66+
Prefer not to say
Gender (Please select)
Male
Female
Non - Binary
Prefer to self-describe
Prefer not to say
Do you consider yourself to have a disability under the Equality Act 2010?
Sexual Orientation
Heterosexual / Straight
Gay / Lesbian
Bisexual
Other
Prefer not to say

Data Privacy Policy Consent Form

I confirm that I have received, read, and understood the Company’s Recruitment Privacy Notice and Data Privacy Policy.

I understand that the Company will collect, use, store, and process my personal information for the purposes of recruitment, pre-employment checks, safeguarding requirements, and, where applicable, ongoing employment administration.

I understand that this may include personal information such as:

  • contact details

  • employment history

  • qualifications and training records

  • references

  • PVG / Disclosure Scotland information

  • SSSC registration details

  • right to work and immigration documentation

  • health information where relevant to reasonable adjustments or fitness to work

  • payroll and employment records where employment is offered

I understand that my information will be handled in accordance with UK GDPR, the Data Protection Act 2018, and company policy.

I understand that my information may be shared with relevant third parties where required by law or for employment-related checks, including Disclosure Scotland, SSSC, referees, payroll providers, and the Home Office where sponsorship applies.

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Flexible Working Availability Form

Employee Availability and Scheduling Record

This form is used to record your regular availability for work to support rota planning and service delivery.

Please ensure the information provided is accurate. Any changes to your regular availability should normally be provided with a minimum of 28 days’ notice, unless due to emergency circumstances.

Weekly Availability

Please indicate your availability for each day and shift.

Select all times you are available
Emergency Contact Information

Medical / Important Information (optional)

Social Media / Image Consent Form

I consent to my image / photo being used for internal company purposes
Yes
No
I consent to my image / photo being used for external company purposes including social media
Yes
No
I consent to video recordings being used for internal training or promotional purposes
Yes
No
I consent to my first name and job title being included alongside images where appropriate
Yes
No
I understand that I must not post confidential company, staff or service user information on social media
Yes
No
I understand that I must follow the company social media policy at all times and not post anything about or towards the business without permission
Yes
No
I understand that after I leave JKL Care I must still maintain service users confidentiality and not contact or post about service users
Yes
No
I agree to not post malicious content and maintain professional towards JKL during and after service
Yes
No
I understand that any breach of confidentiality or professional boundaries may lead to disciplinary action
Yes
No

Working Time Regulations 1998 48-Hour Opt-Out Agreement

Please note: this agreement is not suitable for apprentices or workers under the age of 18 years.

Dear Employee,

Under the Working Time Regulations 1998, a worker’s average weekly working time, including overtime, must not normally exceed 48 hours per week, calculated over a rolling 17-week reference period.

The Regulations allow an employee to voluntarily agree in writing that this limit will not apply.

By signing this form, you are confirming that you agree to opt out of the 48-hour weekly working limit and understand that you may work more than an average of 48 hours per week.

This agreement is entirely voluntary.

You may withdraw your agreement at any time by providing the Company with three months’ written notice, unless otherwise agreed in writing.

Please confirm your agreement by signing below.

Employee Agreement

I agree that the limit specified in Regulation 4(1) of the Working Time Regulations 1998 shall not apply in my case.

I understand that this agreement is voluntary and that I may withdraw my consent by giving the required written notice.

Employee Declaration

I voluntarily agree that the 48-hour average weekly working time limit shall not apply to my employment with JKL Care Services.

I understand that:

  • this agreement is voluntary

  • I am not required to sign this form

  • I may withdraw my agreement by giving written notice

  • the notice period for withdrawal will be 1 month.

  • all other rest breaks and working time protections remain in place

Leave blank if you wish to remain under the working time directive

I voluntarily agree that the 48-hour average weekly working time limit shall not apply to my employment at JKL.
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Pension / NEST Information Notice Workplace Pension Information

Dear Employee,

Soon we will be automatically enrolling you into NEST.

Workplace pension law requires us to enrol eligible employees into a workplace pension scheme that meets legal standards.

We have chosen NEST as our workplace pension provider to meet our employer duties and to help you save for your retirement. NEST provides one retirement pot for life.

You will be automatically enrolled into NEST. If you wish to remain in the scheme, you do not need to do anything.

If you would like to know more about NEST, please visit:


 www.nestpensions.org.uk

Once enrolled, you will receive your welcome pack and be able to activate your online account.

 

Contributions to Your NEST Retirement Pot

We will make employer contributions to your retirement pot and you will pay employee contributions.

If eligible, you may also receive tax relief from the government through the relief at source method.

This means that your pension contributions are made from your pay after tax, and NEST claims the tax relief from HMRC and adds it to your pension pot.

If you pay tax at a higher rate, you may be able to claim additional tax relief through Self-Assessment.

Contributions are based on your qualifying earnings, which may include:

  • basic salary

  • overtime

  • bonuses

  • sick pay

  • taxable earnings

 

Contribution Rates


Employer contribution

3%

Employee contribution

5%

Tax relief

20%

 

Opting Out

If you decide that you do not wish to remain in the pension scheme, you have the right to opt out.

The opt-out period is normally one month from the date your enrolment begins.

You cannot opt out until you have been enrolled and received your NEST ID / welcome pack.

Once you receive your NEST ID, you may opt out by:

  • completing the NEST online opt-out

  • contacting NEST directly

  • completing the internal opt-out request form

If a valid opt-out request is received, any contributions already deducted will be refunded through payroll.

 

Re-Enrolment

If you opt out, you may be automatically re-enrolled at a later date, usually every three years, in line with legal requirements.

You may also request to opt back in at a later date.

 

Further Information

NEST


 Nene Hall


 Lynch Wood Business Park


 Peterborough


 PE2 6FY

Website: www.nestpensions.org.uk


 Member enquiries: 0300 020 0090

For general pension information:


 www.gov.uk/workplace-pensions

Yours sincerely,


 JKL Care Services

 

 

Pension Opt-Out Acknowledgement Form

(Leave Blank if you wish to enrol in Nest Pension)

Date
Month
Day
Year

Important Information

I confirm that I have been automatically enrolled into the Company’s workplace pension scheme.

I understand that:

  • I have the right to opt out within the permitted opt-out period after receiving my enrolment details

  • If I choose to opt out, employer contributions will stop

  • No further pension contributions will be made unless I choose to opt back in at a later date

  • Opting out may affect my future pension benefits

Opt-Out Confirmation

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