Advantage Angels – Registration

    Part 1 - Basic Details

    Do you hold a full UK Driving License?

    History

    Your Right To Work:

    Please select the category that relates to your current immigration status. This status will be subject to relevant checks (not required if British National:

    Please supply details of any visa currently held::

    Your Location:

    Job Applying For:

    Preferred Shift Times:

    References (please supply 2 references)

    Reference 1 - Most Recent Employer:

    Reference 2:

    Part 2 - Night Health Questionnaire

    This questionnaire is intended to assess your fitness for night work. If applicants for night work complete this questionnaire and it indicates a potential medical problem in working nights, they will be offered a full, free health assessment. All employees transferring from days to nights must complete the declaration.

    Gender

    Do you suffer from any of the following conditions, which may be made worse by night work? (Tick all that apply)

    Diabetes, requiring insulin injections to a strict timetableA heart condition or circulatory disorder which affects your physical staminaStomach or intestinal disorder, such as ulcersAny other condition which makes the timing of meals of particular importanceA medical condition affecting sleepA chronic chest conditionAny medical condition requiring medication to a strict timetableAny other medical condition in which the symptoms get worse at night

    APPLICANTS DECLARATION: READ AND CONFIRM BEFORE SIGNING

    (REQUIRED) I confirm that the information given above is complete and correct, and that I understand that any incomplete, untrue or misleading information, in any material sense, given to Advantage Angels, will entitle them to reject my application, withdraw any work offer made, or dismiss me without notice.

    (REQUIRED) By my signature, I gave authority to the employer to contact my GP for further details regarding and of the potential health problems which I have declared above.

    (REQUIRED) If required, I agree to undergo a medical examination in order to assess my suitability for night work.

    (OPTIONAL) I confirm that I have had the opportunity, but I do not wish to have a free health assessment.

    Part 3 - Criminal Declaration

    Have you ever been convicted by the courts or cautioned, reprimanded, or given a final warning by the police? Please give details of offences, penalties and dates in the table below. *(Note that the post you have applied for is exempted under the Rehabilitation of Offenders Act (Exceptions Order) 1974, which means that all convictions, cautions, reprimands and final warnings on your criminal record need to be disclosed.

    Yes (Please provide details below)No

    Have you ever been disqualified from work with vulnerable adults or sanctions imposed by any regulatory body?

    Yes (Please provide details below)No

    Please sign the following declaration. Failure to complete this declaration will result in your application being withdrawn.

    I confirm that the information I have given on this form is correct and complete and I understand that any false information could result in my application being rejected or, if appointed, in my dismissal. I understand that any offer of work made to me will be subject to a further check with the Disclosure and Barring Service (previously Criminal Records Bureau) and I hereby give my consent for Coram to carry out the relevant DBS status checks in line with the DBS Code of Practice. I declare that I am not currently on the DBS Barred List and that I will notify the Human Resources department immediately if I do become barred in future

    Part 4 - Health Questionnaire

    All questions contained in this questionnaire are strictly confidential and will become part of your medical record.

    Marital Status

    SinglePartneredMarriedSeparatedDivorcedWidowed

    Childhood Illness (tick all that apply)

    MeaslesMumpsRubellaChicken PoxRheumatic FeverPolio

    Immunisations (tick all that apply)

    TetanusHepatitisInfluenzaCOVID-19PneumoniaChicken PoxMMRTuberculosis

    Next Of Kin Details

    Part 5 - Working Time Directive Opt-out

    Maximum weekly working time opt out

    Under regulation 4(1) of the Working Time Regulations 1988, you can only work more than 48 hours a week on average (including overtime, and time worked for other employers or businesses) if you have agreed to do so in writing.

    This statement is an agreement between us (yourself and Advantage Angels) that the limit on weekly working time does not apply to you and that your working time can exceed an average of 48 hours per week.
    You can end this agreement at any time by giving at least one months’ notice to Advantage Angels in writing, otherwise it will continue.

    Please note – do not sign this agreement if you do not wish to work more than 48 hours per week. Any candidate on a restricted working time must not sign this agreement unless there is no restriction on the hours they are permitted to work each week.

    I agree that I may work for more than an average of 48 hours a week. If I change my mind, I will give Advantage Angels one months’ notice in writing to end this agreement.

    Part 6 - Bank Details (optional)

    Timesheets

    It is your responsibility to get all of your timesheets signed at the end of your shift by an appropriate member of staff from the care home. All timesheets must be signed otherwise shifts cannot be claimed and paid. Timesheets must be sent to your Branch Manager immediately after your shift, ready for processing. All timesheets must then be sent to timesheets@advantageangels.co.uk every Monday morning by 09:00am so that the weeks shifts are in the system.


    Part 7 - Declarations

    • Are you related to or the partner of any existing employee or committee member of Advantage Angels?

    • The information I have given on this form is true and accurate to the best of my knowledge
    • I am not subject to any immigration controls or restrictions which prohibit my undertaking work in the UK
    • Under the Rehabilitation of Offenders Act I understand that I will be asked to declare in writing whether I have been convicted of any offences in a Court of Law and if so to provide details of the offence(s). I understand that failure to disclose such convictions may result in dismissal or disciplinary action by Advantage Angels
    • All Advantage Angels employees will require a DBS check before commencing employment. If you do not have an existing DBS certificate, Advantage Angels will pay the cost of the DBS check. Please note, if your contract is terminated or you resign within the first 6 months of employment, this cost will be deducted from your final salary.
    • As a DBS applicant, I will ensure that I read and understand the DBS Privacy Policy before I submit my DBS application to Advantage Angels for processing.
    • As a DBS applicant, I will ensure that I read and understand the DBS Privacy Policy before I submit my DBS application to Advantage Angels for processing.
    • All job applications are retained for 6 months, and your data is used for recruitment purposes only. Please inform us if you would like your application destroyed before this time by contacting Advantage Angels by Email: recruitment@advantageangels.co.uk
    • We will never share your data and will ensure it is kept safe and secure.
    • I understand that any information given in relation to my application will be held by Advantage Angels and falls within the provisions of the General Data Protection Regulation 2018. I also give consent for my personal information being retained and used to process my application for future employment.
    • You can request our privacy policy. In this policy, you will find information about our compliance with GDPR (data protection law). You can find how to send us a request to let you access your data that we have collected, request us to delete your data, correct any inaccuracies or restrict our processing of your data.
    • In line with GDPR, we ask that you do NOT send us any information that can identify children or any of your Sensitive Personal Data (racial or ethnic origin, political opinions, religious or philosophical beliefs, trade union membership, data concerning health or sex life and sexual orientation, genetic and/or biometric data) in your CV and application documentation. Following this notice, any inclusion of your Sensitive Personal Data in your CV/application documentation will be understood by us as your expressed consent to process this information going forward. Please also remember to not mention anyone’s information or details (e.g., referees) who have not previously agreed to their inclusion.
    • By signing this document you accept that as part of the GDPR new law which came into effect in May 2018, Advantage Angels are conscious that all personal information given is processed in a fairly and lawful manner. Information is processed only for specified and lawful purposes. Please be advised that some information may be shared with only integral third parties, personal data will be kept securely and not kept longer than necessary, Consequently, data will be destroyed suitably.
    • You have the right to lodge a complaint, if you would like to exercise this right, please contact recruitment@advantageangels.co.uk
    • You agree to work as a 'deemed worker' under current HMRC IR35 regulations. As a deemed worker your tax and national insurance deductions shall be deducted from your monthly or weekly pay and paid directly to HMRC on your behalf. As a deemed worker you are not entitles to statutory benefit of employment. After three months you have the option to apply for a full-timed salaried position acceptance of this position will be based on your previous three months performance.
    • Should you decide to leave Advantage Angels Limited at any point after claiming shifts and not give reasonable notice Advantage Angels Limited has the right to withhold any monies due to of loss of revenue or in the event that the company has to find alternative cover at a premium rate.
    • All training certifications are restricted to workers whilst they work for Advantage Angels Limited. They are non transferable to alternative providers.
    • Whilst working with Advantage Angels you will be working under IR35 rules and regulations. These rules and regulations must be followed and all details regarding the IR35 rules and regulations can be found on our website in our terms and conditions.
    • Once you have completed 48 full shifts for us, you will be granted access to the training certificates that are used as evidence to show completion of training. If you would like access to these training certificates before completion of 48 shifts, then these certificates will be available to purchase.
    • If you are a registered nurse who is applying to work with us, you will be eligible for assistance of payment for your NMC pin revalidation once you have completed 48 full shifts, you will not be eligible for this assistance before 48 shifts have been completed

    By signing this document, you agree to all of Advantage Angels Terms of Engagement which can be found on our website: www.advantageangels.co.uk