EMPLOYMENT HISTORY AND WORK EXPERIENCE

Please give details of your employment over the last 10 years commencing with your most recent job and including any agencies worked for.
Where applicable please explain any gaps in your employment and provide evidence e.g. maternity, looking for work, studying, unemployed
etc.

REFERENCES

Please provide at least two referees who would give reference on your character, work experience, and suitability for the post applied for. Referees must be in a senior position to you. All will be contacted, therefore please inform the referees of the fact that you have used their name. if you are unable to provide the required references, please discuss the matter with us. PLEASE NOTE: If applying to work with children; two professional references are required

REHABILITATION OF OFFENDERS ACT 1974 AND OTHER DISCLOSURES

In view of the nature of the work for which you are applying, the post is considered to be exempt from the provisions of the Rehabilitation of
Offenders Act 1974 as contained within the Exceptions Amendment Order 1986. Applicants are required to give details of all convictions for
criminal offences, including pending convictions and those which would otherwise be considered “spent”. Failure to provide details of
convictions could result in dismissal or disciplinary action. If there are no convictions, please state “none”. Having a criminal record will not
necessarily bar you from working with us. Gims Care Solutions complies fully with the DBS Code of Practice regarding the correct handling, use,
storage retention and disposal of Disclosures and Disclosure information. We make every subject of a DBS Check aware of the existence of the
DBS Code of Practice and make a copy available on request.

DISCLOSURE AND BARRING SERVICE (DBS) CHECK

I authorise Gims Care Solutions to carry out a DBS check on my behalf as and when required, also to retain a copy of my DBS and
update service checks. I understand that before I can commence work with Gims Care Solutions, I need to have completed a DBS
Check.

In keeping with current industry standards and Government requirements, all staff members involved with the provision of Care to Children and
Adults at risk are required to complete an Enhanced Disclosure form for the Disclosure and Barring Service (DBS). No applicant will be offered
work with Anytime Recruitment Ltd prior to these DBS checks.

CONFIDENTIALITY

During the course of your employment you may see, hear or have access to information on matters of a confidential nature relating
to the work of the organisation, or to the health and personal affairs of clients. Under no circumstances should this information
be divulged or passed on to any unauthorised person or organisation, either during the course of your employment or any time
after. You have got a statutory obligation regarding this.

I have read and understand the above and agree that breach of such confidentiality will be regarded as gross misconduct, which
could result in disciplinary action or dismissal.

WORKING TIME DIRECTIVE

The Working Times regulations 1998 (“The Regulations”) require Gims Care Solutions (“The Company”) to limit your average
weekly working time to 48 hours unless you agree with The Company that the limit shall not apply to you. The Company wished
to have an agreement with you. It proposes an agreement (which will apply until terminated by notice) on the basis that:

a. The 48-hour limit on average weekly time will not apply to you.
b. You may terminate the agreement (so that the 48-hour time limit would apply to you) by giving the person at The Company
to whom you usually report 4 weeks’ written notice. Under the Regulations, The Company must keep records relating to
your working time. This is the case whether or not you reach an agreement with The Company about waiving working time
limits.

If, however, you do wish to agree to this opt-out, then please sign where indicated on the statement below. You may withdraw
your agreement by a 4 weeks’ notice in writing, and you will not be subjected to any detriment if you do not give your agreement.

BANK DETAILS

(Complete all sections accurately – your money will be paid directly into your
bank account)

AREAS OF EXPERIENCE

(Enter the Length of Experience)

THIRD PARTY DECLARATION

I hereby allow any information relating to my registration with Gims Care Solutions to be shared with relevant third parties, including
external audits and frameworks. This will be overseen by the governance lead for Gims Care Solutions.