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07735552647
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Modern Slavery & Human Trafficking Statement
Contact
Recruitment Services
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SECTION 1 : Personal Details
Post Applied For:
*
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
Last Name
Phone
*
Email Address
*
Sex
*
Male
Female
Prefer Not To Say
Date of Birth
*
Are You Over 18:
*
Yes
No
National Insurance Number (NI):
*
Are you eligible to work in the UK?
*
Yes
No
Nationality:
*
Do you have a current full driving license:
*
Yes
No
Do you have your own transport:
*
Yes
No
Street Address
City
State/Province
ZIP / Postal Code
Proof of Address:
Please upload 2 (two) items stating your full name and current home address- Accepted Documents – A utility bill (gas, electric, satellite television, – Landline phone bill) issued within the last three months – Local authority council tax bill for the current council tax year – Bank, Building Society statement (last three months) – Original mortgage statement from a recognised lender issued for the last full year – HMRC correspondence within the current financial year (e.g. P45 / P60, self-assessment letter, tax demand, etc.)
Proof of Address 1
*
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Proof of Address 2
*
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No file chosen
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PRIVATE AND CONFIDENTIAL
Position Applied For:
*
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
*
Last Name
*
Date of Birth
*
Place of Birth
*
Age
*
Nationality
*
National Insurance (NI) No:
*
Contact Number
*
General Practitioner Details:
General Practitioner:
*
Street Address
*
City
State/Province
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre & Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Employer : Fadera Care and Recruitment Services Limited
PAYE Reference:
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
Last Name
Street Address
City
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre & Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Phone
*
Email
*
Date of Birth
*
Gender
*
Gender
Male
Female
Prefer Not To Say
National Insurance (NI) No:
*
Payroll Number:
Contact Information(In case of emergency)
Name of person to contact:
*
Relationship to you:
*
Telephone
*
Mobile Number:
*
Bank Details:
Name of Bank
*
Account Holders Name:
*
Account Number
*
Sort Code
*
Non-Disclosure Form
During the course of my engagement with Client (referred to as the ‘Client’), I may learn of confidential information relating to the Client. Confidential information includes matters not generally known outside the Client, and includes various developments, inventions, improvements, methods, etc., relating to products, services marketed or used by the Client (e.g. relating to sales, costs, profits, organisation, customer lists, pricing methods, etc.). I agree not to disclose any confidential information to others or to make use of it either during or after my engagement by the Client, whether or not such information is produced by my own efforts, except as expressly permitted in writing by the Client. Also, I may learn of apparatus, methods, ways of business, etc., which in themselves are generally known but whose use by the Client is not generally known, and I agree not to disclose to others such use, either during or after my engagements. All inventions, discoveries, developments and improvements (hereafter referred to as ‘Inventions’) made or conceived during the course of my engagement with the Client, whether the same are patentable or not, shall become and remain the sole and exclusive property of the Client. I agree to notify immediately the Client in writing of such Inventions, and hereby transfer all rights title and interest in and to any such Inventions to the Client. I hereby assign to the Client all rights title and interest in and to all copyrights on all writings, documents, reports, computer programs and other works made or written by me during the course of my engagement with the Client. My obligations under this Agreement shall survive the termination of my engagement with the Client regardless of the manner of such termination, and shall be binding upon my heirs, executors and administrators.
Signed:
Name
Date
Submit
Eagle Care Executive Recruitment Services
First Name
*
Last Name
Email Address
*
Phone
*
Job title
*
Job sector:
*
Job sector
Health Care
Social Care
Organisations
*
Organisations
NHS
Local Authorities
Private Individual
Recruitment Agency
Radio
*
Permanent Staff
Temporary Staff
When would you like the required support:(if permanent)
*
Time
*
Hours
Minutes
Employment Duration (If Temporary)
Less than a month
1-6 months
1-3 years
Over 3 years
Never used
Where are you Located:
*
Submit
07735552647, 07411169585
info@eaglecareexecutive.com
32 Galapagos Grove Newton Leys MK3 5NX Milton, Keynes
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